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)

Makoto Naganuma 1Taku Kobayashi 2Reiko Kunisaki 3Katsuyoshi Matsuoka 4Shojiro Yamamoto 5Ami Kawamoto 6Daisuke Saito 7Kosaku Nanki 8Kazuyuki Narimatsu 9Hisashi Shiga 10Motohiro Esaki 11Shinichiro Yoshioka 12Shingo Kato 13Masayuki Saruta 14Shinji Tanaka 15Eriko Yasutomi 16Kaoru Yokoyama 17Kei Moriya 18Yoshikazu Tsuzuki 19Makoto Ooi 20Mikihiro Fujiya 21Atsushi Nakazawa 22Takayuki Abe 23Tadakazu Hisamatsu 6Japanese UC Study Group J Gastroenterol. 2023 Dec;58(12):1198-1210. doi: 10.1007/s00535-023-02048-w. 

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.

Real-world efficacy and safety of advanced therapies in hospitalized patients with ulcerative colitis – PubMed (nih.gov)

Real-world efficacy and safety of advanced therapies in hospitalized patients with ulcerative colitis | Journal of Gastroenterology (springer.com)

Scientific corner

P442 The additional value of cytapheresis therapy in patients with severe ulcerative colitis treated with oral tacrolimus

S TakahashiM ColvinJ ToyosawaM IshidaT KagawaS KuraokaY AoyamaK OkamotoI SakakiharaK IzumikawaK YamamotoS TanakaM MatsuuraS IshikawaM WatoT HasuiT Inaba, Journal of Crohn’s and Colitis, Volume 12, Issue supplement_1, February 2018

Cytapheresis therapy as an additional therapy to oral tacrolimus is effective in patients with severe ulcerative colitis.

)https://academic.oup.com/ecco-jcc/article/12/supplement_1/S328/4808317

Scientific corner

Successful remission of ulcerative colitis flare-up during pregnancy with adsorptive granulomonocytapheresis plus tacrolimus

Tomoyoshi Shibuya 1Keiichi Haga 1Masato Kamei 1Koki Okahara 1Shoko Ito 1Masahito Takahashi 1Osamu Nomura 1Takashi Murakami 1Masae Makino 1Tomohiro Kodani 1Dai Ishikawa 1Naoto Sakamoto 1Taro Osada 1Tatsuo Ogihara 1Sumio Watanabe 1Akihito Nagahara 1 , Intest Res. 2018 Jul;16(3):484-488.

Our experience indicates that GMA, as a non-drug therapeutic intervention with a favorable safety profile, plus tacrolimus might be a relevant treatment option for patients with active IBD during pregnancy. A future study of a large cohort of pregnant patients should strengthen our findings.

https://pubmed.ncbi.nlm.nih.gov/30090048/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6077305/pdf/ir-16-484.pdf

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