Current Drug Targets

Francis J. Castellino
Kleiderer-Pezold Professor of Biochemistry
Director, W.M. Keck Center for Transgene Research
Dean Emeritus, College of Science
230 Raclin-Carmichael Hall, University of Notre Dame
Notre Dame, IN 46556
USA

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Does Anti-TNF Therapy Reduce the Requirement for Surgery in Ulcerative Colitis? A Systematic Review

Author(s): Jerome Filippi, Patrick B. Allen, Xavier Hebuterne and Laurent Peyrin-Biroulet

Affiliation: Department of Gastroenterology, University Hospital of Nancy, Henri Poincare University, Nancy 1, Allee du Morvan, 54 511 Vandoeuvre-les-Nancy, France.

Abstract:

Infliximab has demonstrated its efficacy in moderate to severe ulcerative colitis. The Active Ulcerative Colitis Trial (ACT) -1 and 2 have demonstrated the beneficial impact of infliximab on the short-term colectomy rate. However, data evaluating this outcome beyond one year remains scarce. To provide evidence on the potential impact of infliximab on the long-term colectomy rate in patients suffering from ulcerative colitis, data was reviewed from randomized and controlled studies, referral center studies and population-based studies, in adult and pediatric populations. In the prebiologic era, 9-33%, 50% and 29% of adult patients with ulcerative colitis underwent colectomy in clinical trials, referral center studies and population-based cohorts, respectively. In the pediatric population, 9-61% and 8-20% underwent colectomy in referral centers and population-based cohorts, respectively. Between 10 and 36% of adult patients treated with infliximab for ulcerative colitis underwent colectomy in clinical trials, referral center studies and population-based cohorts. In the pediatric population treated with infliximab, long-term data is lacking, with colectomy rates ranging from 16 to 28%. Whether infliximab proves to be a disease modifying treatment in ulcerative colitis in the long term remains to be elucidated and will require further long-term prospective studies.

Keywords: Colectomy, Ulcerative Colitis, Inflixamab, Adalimumab, Tumor Necrosis Factor, ACT 1, ACT 2

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Article Details

VOLUME: 12
ISSUE: 10
Page: [1440 - 1447]
Pages: 8
DOI: 10.2174/138945011796818153