PMID- 38445785
OWN - NLM
STAT- MEDLINE
DCOM- 20240423
LR  - 20240423
IS  - 1365-2036 (Electronic)
IS  - 0269-2813 (Linking)
VI  - 59
IP  - 10
DP  - 2024 May
TI  - Effectiveness and safety of a third-line rescue treatment for acute severe 
      ulcerative colitis refractory to infliximab or ciclosporin (REASUC study).
PG  - 1248-1259
LID - 10.1111/apt.17938 [doi]
AB  - BACKGROUND: The advent of new therapeutic agents and the improvement of 
      supporting care might change the management of acute severe ulcerative colitis 
      (ASUC) and avoid colectomy. AIMS: To evaluate the colectomy-free survival and 
      safety of a third-line treatment in patients with ASUC refractory to intravenous 
      steroids and who failed either infliximab or ciclosporin. METHODS: Multicentre 
      retrospective cohort study of patients with ASUC refractory to intravenous 
      steroids who had failed infliximab or ciclosporin and received a third-line 
      treatment during the same hospitalisation. Patients who stopped second-line 
      treatment due to disease activity or adverse events (AEs) were eligible. We 
      assessed short-term colectomy-free survival by logistic regression analysis. 
      Kaplan-Meier curves and Cox regression models were used for long-term assessment. 
      RESULTS: Among 78 patients, 32 received infliximab and 46 ciclosporin as 
      second-line rescue treatment. Third-line treatment was infliximab in 45 (58%), 
      ciclosporin in 17 (22%), tofacitinib in 13 (17%) and ustekinumab in 3 (3.8%). 
      Colectomy was performed in 29 patients (37%) during follow-up (median 21 weeks). 
      Of the 78 patients, 32 and 18 were in clinical remission at, respectively, 12 and 
      52 weeks. At the last visit, 25 patients were still on third-line rescue 
      treatment, while 12 had stopped it due to clinical remission. AEs were reported 
      in 26 (33%) patients. Two patients died (2.6%), including one following 
      colectomy. CONCLUSION: Third-line rescue treatment avoided colectomy in over half 
      of the patients with ASUC and may be considered a therapeutic strategy.
CI  - (c) 2024 John Wiley & Sons Ltd.
FAU - Garcia, Maria Jose
AU  - Garcia MJ
AUID- ORCID: 0000-0002-6517-7005
AD  - Gastroenterology and Hepatology Department, Hospital Universitario Marques de 
      Valdecilla, Grupo de Investigacion Clinica y Traslacional en Enfermedades 
      Digestivas, Instituto de Investigacion Valdecilla (IDIVAL), Universidad de 
      Cantabria, Santander, Spain.
FAU - Riestra, Sabino
AU  - Riestra S
AUID- ORCID: 0000-0002-9383-3698
AD  - Gastroenterology Department, Hospital Universitario Central de Asturias, 
      Instituto de Investigacion Sanitaria del Principado de Asturias (ISPA), Oviedo, 
      Spain.
FAU - Amiot, Aurelien
AU  - Amiot A
AUID- ORCID: 0000-0001-6676-1222
AD  - Department of Gastroenterology, CHU Bicetre, Universite Paris Saclay, Paris, 
      France.
FAU - Julsgaard, Mette
AU  - Julsgaard M
AUID- ORCID: 0000-0003-3070-8950
AD  - Department of Gastroenterology and Hepatology, Aarhus University Hospital, 
      Aarhus, Denmark.
AD  - Department of Clinical Medicine, Center for Molecular Prediction of Inflammatory 
      Bowel Disease [PREDICT], Aalborg University, Copenhagen, Denmark.
FAU - Garcia de la Filia, Irene
AU  - Garcia de la Filia I
AD  - Gastroenterology Department, Hospital Universitario Ramon y Cajal, Madrid, Spain.
FAU - Calafat, Margalida
AU  - Calafat M
AUID- ORCID: 0000-0003-2335-3792
AD  - Gastroenterology Department, Hospital Universitari Germans Trias i Pujol, Centro 
      de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas 
      (CIBEREHD), Barcelona, Spain.
FAU - Aguas, Mariam
AU  - Aguas M
AD  - Gastroenterology Department, La Fe University and Polytechnic Hospital, Health 
      Research Institute La Fe, Valencia, Spain.
FAU - de la Pena, Luisa
AU  - de la Pena L
AD  - Gastroenterology Department, Bellvitge University Hospital, Barcelona, Spain.
FAU - Roig, Cristina
AU  - Roig C
AD  - Gastroenterology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, 
      Spain.
FAU - Caballol, Berta
AU  - Caballol B
AD  - Gastroenterology Department, Hospital Clinic, Institut d'Investigacions 
      Biomediques August Pi i Sunyer (IDIBAPS), Centro de Investigacion Biomedica en 
      Red de Enfermedades Hepaticas y Digestivas (CIBEREHD), Barcelona, Spain.
FAU - Casanova, Maria Jose
AU  - Casanova MJ
AUID- ORCID: 0000-0001-8233-9638
AD  - Gastroenterology Department, Hospital Universitario de La Princesa, Instituto de 
      Investigacion Sanitaria Princesa (IIS-Princesa), Universidad Autonoma de Madrid 
      (UAM) and Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y 
      Digestivas (CIBEREHD), Madrid, Spain.
FAU - Farkas, Klaudia
AU  - Farkas K
AD  - Department of Medicine, University of Szeged, Szeged, Hungary.
FAU - Boysen, Trine
AU  - Boysen T
AD  - Gastro Unit, Medical Division, Copenhagen University Hospital-Amager and 
      Hvidovre, Hvidovre, Denmark.
AD  - Copenhagen Center for Inflammatory Bowel Disease in Children, Adolescents and 
      Adults, Copenhagen University Hospital-Amager and Hvidovre, Hvidovre, Denmark.
AD  - Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
FAU - Bujanda, Luis
AU  - Bujanda L
AD  - Department of Gastroenterology, Biodonostia Health Research Institute, Centro de 
      Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas (CIBEREHD), 
      Universidad del Pais Vasco (UPV/EHU), San Sebastian, Spain.
FAU - Cuaran, Camila
AU  - Cuaran C
AD  - Gastroenterology Department, Hospital Universitario Miguel Servet, Zaragoza, 
      Spain.
FAU - Dobru, Daniela
AU  - Dobru D
AD  - Gastroenterology Department, University of Medicine and Pharmacy, Science and 
      Tehnology "G E Palade" Tg.Mures, Targu-Mures, Romania.
FAU - Fousekis, Fotios
AU  - Fousekis F
AD  - Department of Gastroenterology, University Hospital of Ioannina, Ioannina, 
      Greece.
FAU - Gargallo-Puyuelo, Carla Jerusalen
AU  - Gargallo-Puyuelo CJ
AD  - Department of Gastroenterology, University Clinic Hospital Lozano Blesa, 
      Institute for Health Research Aragon (IIS Aragon), Zaragoza, Spain.
FAU - Savarino, Edoardo
AU  - Savarino E
AD  - Department of Surgery, Oncology and Gastroenterology (DiSCOG), Gastroenterology 
      Unit, Azienda Ospedale Universita di Padova (AOUP), University of Padua, Padua, 
      Italy.
FAU - Calvet, Xavier
AU  - Calvet X
AD  - Gastroenterology Department, Servei d'Aparell Digestiu, Parc Tauli, Hospital 
      Universitari, Institut d'Investigacio i Innovacio Parc Tauli, Departamento de 
      Medicina, Universitat Autonoma de Barcelona, Centro de Investigacion Biomedica en 
      Red de Enfermedades Hepaticas y Digestivas (CIBEREHD), Instituto de Salud Carlos 
      III, Sabadell, Spain.
FAU - Huguet, Jose Maria
AU  - Huguet JM
AUID- ORCID: 0000-0001-6486-1262
AD  - Digestive Diseases Department, General University Hospital of Valencia, Valencia, 
      Spain.
FAU - Kupcinskas, Limas
AU  - Kupcinskas L
AD  - Institute for Digestive Research, Lithuanian University of Health Sciences, 
      Kaunas, Lithuania.
FAU - Lopez-Cardona, Julia
AU  - Lopez-Cardona J
AD  - IBD Unit, Guy's and St Thomas' Hospital, London, UK.
FAU - Raine, Tim
AU  - Raine T
AD  - Department of Gastroenterology, Cambridge University Hospitals NHS Foundation 
      Trust, Cambridge, UK.
FAU - van Oostrom, Joep
AU  - van Oostrom J
AD  - Department of Gastroenterology and Hepatology, Amsterdam UMC, Amsterdam, The 
      Netherlands.
FAU - Gisbert, Javier P
AU  - Gisbert JP
AUID- ORCID: 0000-0003-2090-3445
AD  - Gastroenterology Department, Hospital Universitario de La Princesa, Instituto de 
      Investigacion Sanitaria Princesa (IIS-Princesa), Universidad Autonoma de Madrid 
      (UAM) and Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y 
      Digestivas (CIBEREHD), Madrid, Spain.
FAU - Chaparro, Maria
AU  - Chaparro M
AUID- ORCID: 0000-0002-9275-4242
AD  - Gastroenterology Department, Hospital Universitario de La Princesa, Instituto de 
      Investigacion Sanitaria Princesa (IIS-Princesa), Universidad Autonoma de Madrid 
      (UAM) and Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y 
      Digestivas (CIBEREHD), Madrid, Spain.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20240306
PL  - England
TA  - Aliment Pharmacol Ther
JT  - Alimentary pharmacology & therapeutics
JID - 8707234
RN  - B72HH48FLU (Infliximab)
RN  - 83HN0GTJ6D (Cyclosporine)
RN  - 0 (Gastrointestinal Agents)
RN  - 0 (Immunosuppressive Agents)
SB  - IM
MH  - Humans
MH  - *Colitis, Ulcerative/drug therapy/surgery
MH  - *Infliximab/therapeutic use/adverse effects
MH  - Male
MH  - Female
MH  - *Cyclosporine/therapeutic use/adverse effects
MH  - Retrospective Studies
MH  - Adult
MH  - Middle Aged
MH  - *Gastrointestinal Agents/therapeutic use/adverse effects
MH  - *Colectomy
MH  - Treatment Outcome
MH  - Acute Disease
MH  - Immunosuppressive Agents/therapeutic use/adverse effects
MH  - Severity of Illness Index
EDAT- 2024/03/06 12:44
MHDA- 2024/04/23 18:50
CRDT- 2024/03/06 08:31
PHST- 2024/01/03 00:00 [revised]
PHST- 2023/12/14 00:00 [received]
PHST- 2024/02/24 00:00 [accepted]
PHST- 2024/04/23 18:50 [medline]
PHST- 2024/03/06 12:44 [pubmed]
PHST- 2024/03/06 08:31 [entrez]
AID - 10.1111/apt.17938 [doi]
PST - ppublish
SO  - Aliment Pharmacol Ther. 2024 May;59(10):1248-1259. doi: 10.1111/apt.17938. Epub 
      2024 Mar 6.