نبذة مختصرة : There is insufficient evidence comparing the outcomes of tacrolimus-based remission induction therapy with infliximab in refractory ulcerative colitis (UC) and evidence regarding optimal strategies after tacrolimus-based remission induction therapy. We conducted a multi-institutional retrospective study of patients with UC treated with tacrolimus or infliximab between January 2010 and March 2019. The proportion of clinical remission at week 8 and cumulative colectomy-free rate were examined using propensity score matching analysis. The predictors for colectomy after tacrolimus induction were also investigated. Ninety patients in the tacrolimus group and 151 in the infliximab group were enrolled. The proportion of patients in clinical remission at week 8 was 65.2% in the matched tacrolimus group and 37.3% in the matched infliximab group (P = 0.0016), and the long-term colectomy-free rate was lower in the matched tacrolimus group than in the matched infliximab group (P = 0.0003). After clinical remission with tacrolimus, a serum albumin level of ≤ 3.5 g/dL at week 8 was extracted as a factor predicting colectomy (area under the curve: 0.94). Tacrolimus showed a higher remission induction effect for UC compared to infliximab. However, a high rate of colectomy after transition to maintenance treatment was found to be a concern for tacrolimus therapy.
Competing Interests: Competing interests: Takeo Yoshihara received lecture fees from EA Pharma Co., Ltd., Janssen Pharmaceutical K.K., Mitsubishi Tanabe Pharma Corporation, and Nippon Kayaku Co., Ltd. Takahiro Amano received lecture fees from Janssen Pharmaceutical K.K. and Mitsubishi Tanabe Pharma Corporation. Shinichiro Shinzaki received personal fees from AbbVie Inc., EA Pharma Co., Ltd., Eisai Co., Ltd., Janssen Pharmaceutical K.K., Mitsubishi Tanabe Pharma Corporation, and Nippon Kayaku Co., Ltd., and scholarship grants from AbbVie Inc., EA Pharma Co., Ltd., and Nippon Kayaku Co., Ltd. Satoshi Egawa received lecture fees from Mitsubishi Tanabe Pharma Corporation and Janssen Pharmaceutical K.K. Satoshi Hiyama1 received lecture fees from Mitsubishi Tanabe Pharma Corporation and AbbVie Inc. Hideki Iijima received lecture fees from AbbVie Inc., Janssen Pharmaceutical K.K., EA Pharma Co., Ltd., Eisai Pharmaceutical Co., Ltd., Mitsubishi Tanabe Pharma Corporation, and Mochida Pharmaceutical Co., Ltd. Yoshito Hayashi received lecture fees from EA Pharma Co., Ltd and Nippon Kayaku Co., Ltd. Tetsuo Takehara received lecture fees from AbbVie Inc.,consigned/joint research expenses from AbbVie Inc., Janssen Pharmaceutical K.K., and Mitsubishi Tanabe Pharma Corporation, and scholarship donations from AbbVie Inc., EA Pharma Co., Ltd., Nippon Kayaku Co., Ltd. and Mitsubishi Tanabe Pharma Corporation. None of the disclosures mentioned above are related to this study. The remaining authors do not have any conflicts of interest to disclose. Ethics approval: This study was approved by the Ethics Committee of Osaka University Hospital and by the Ethics Committees of the respective institutions (the ethics approval number: 18208). Patient consent: The requirement for written informed consent was waived by allowing the participants to opt out because of the study’s retrospective nature.
(© 2024. The Author(s).)
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