Negrar (Vr, Italy).; Department of General Surgery, Ospedale Sacro Cuore Don Calabria. Negrar (Verona, Italy). Objective: Infliximab (IFX) has been shown to be effective as rescue therapy (tp) in patients (pts) with severe ulcerative colitis (UC) refractory to intravenous (i.v.) steroids. However little is known about long-term benefits and predictive factors of clinical outcome. Furthermore, it’s still debated, whether mucosal healing (MH) is achievable in these pts. The aim of this single centre open-lable study is to provide further data on long-term effect of IFX in pts treated as rescue tp, in terms of sustained
clinical response (CR) and MH. Methods: From Jan 2009 to Dec 2010, 14 in-pts with LEE011 supplier severe UC (according to Truelove and Witts criteria) were recruited at the Gastroenterology Department of Negrar Hospital (Vr-Italy). Age, sex, extent of UC and duration of disease were recorded. All were treated with i.v. metilprednisolone 1 mg/kg: at day seven 9 pts (64.2%) were steroid refractory. 1 underwent urgent colectomy and 8 were treated with IFX (5 mg/kg for induction period and subsequently for 52 weeks). After 1 year we performed colonoscopy to assess MH. The endoscopies were scored using the Mayo Endoscopic Score (MS). We defined MH as a subscore of 0 or 1. Results: After IFX induction 1/8 pts
(12.5%) failed to respond and underwent elective colectomy. 7/8 pts (87.5%) received 1 year IFX tp. Y-27632 mouse After 12 months 1/7 didn’t respond and underwent elective colectomy. 6 pts, 5 males, age 25–51 years, 4 pancolitis, 2 left-sided colitis, had sustained CR after 1 year IFX tp. Out of them 5 pts had recently diagnosed CU (mean disease duration 16.8 months) and started IFX as a first selleck compound line tp after steroid refractoriness. 1/6 pts had partial
CR. After 1 year 2/6 pts (33.3%) achieved MH. 3/6 had a MS of 2, 1/6 a MS of 3. The colectomy rate after 1 year IFX tp was 14.3%. Not responders pts (2 colectomies and 1 partial CR at 1 year), age 37–64 years, had long lasting pancolitis (over 10 years). Conclusion: Our study confirms the efficacy of IFX as rescue tp in pts refractory to i.v. steroids. 85.7% of pts, after 1 year tp, avoided colectomy. Long lasting disease, older age and extent of UC were associated with a less favorable outcome. CR in severe UC did not predict MH: 33.3% of pts with a sustained CR achieved MH. It seems that early use of IFX can be associated with improved long-term clinical outcomes in severe UC, however further studies are needed. Key Word(s): 1. Infliximab; 2. rescue therapy; 3. clinical response; 4. mucosal healing; Presenting Author: METIN BASARANOGLU Corresponding Author: METIN BASARANOGLU Affiliations: Ankara YIH Objective: Crohn’s disease (CD) is a disease that causes inflammation or swelling of any part of the gastrointestinal (GI) tract.