Makoto Naganuma 1, Taku Kobayashi 2, Reiko Kunisaki 3, Katsuyoshi Matsuoka 4, Shojiro Yamamoto 5, Ami Kawamoto 6, Daisuke Saito 7, Kosaku Nanki 8, Kazuyuki Narimatsu 9, Hisashi Shiga 10, Motohiro Esaki 11, Shinichiro Yoshioka 12, Shingo Kato 13, Masayuki Saruta 14, Shinji Tanaka 15, Eriko Yasutomi 16, Kaoru Yokoyama 17, Kei Moriya 18, Yoshikazu Tsuzuki 19, Makoto Ooi 20, Mikihiro Fujiya 21, Atsushi Nakazawa 22, Takayuki Abe 23, Tadakazu Hisamatsu 6; Japanese UC Study Group J Gastroenterol. 2023 Dec;58(12):1198-1210. doi: 10.1007/s00535-023-02048-w.
Scientific corner
Real-world effectiveness and safety of advanced therapies for the treatment of moderate-to-severe ulcerative colitis (UC): evidence from a systematic literature review (SLR)
Background: This multicenter observational cohort study aimed to evaluate the utilization and short-term efficacy of advanced therapy (AT) in hospitalized patients with acute severe ulcerative colitis (ASUC).
Methods: In total, 221 patients with ASUC were enrolled between August 2020 and July 2021. The primary endpoint was clinical remission (CR, defined as a patient-reported outcome score < 2 with no blood in the stool) rate on Day 7 and 14 in hospitalized patients who received corticosteroids (CS) and AT.
Results: Among patients with ASUC, 120 and 101 patients received CS or any AT as first-line treatment, respectively. The CR rates on Day 7 and 14 were 22.5% and 35.0%, respectively, in hospitalized patients who received CS as first-line treatment. Most patients who used ATs had CS-dependent or frequent recurrences. Eight different ATs (apheresis, tacrolimus, infliximab, golimumab, tofacitinib, vedolizumab, ustekinumab, and cyclosporine) were used as first-line treatment in patients with ASUC, and the CR rates on Day 7 and 14 were 16.8% and 29.7%, respectively. Twenty-five patients received the second ATs after hospitalizations, and the CR rates on Day 7 and 14 were 0% and 12%, respectively. The CR rates on Day 14 were significantly higher in patients who changed to AT than in those whose dose of CS increased (34.0% vs 10.7%, p = 0.020) among patients who had already used CS before hospitalization.
Conclusion: Most first-use ATs were effective for patients with ASUC, while second-use ATs might have had limited benefits in inducing CR. These findings may contribute to considerations for the management of hospitalized patients.
Contact UsFor more information
Contact Us