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Infliximab for Ulcerative Colitis

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Book cover Medical Therapy of Ulcerative Colitis

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Abstract

Ulcerative colitis (UC) is characterized by recurring episodes of inflammation limited to the mucosal layer of the colon. Inflammatory episodes give rise to rectal bleeding, diarrhea, and abdominal pain. Most patients with UC can be treated successfully with a symptom-focused step-up approach comprising 5-aminosalicylates, corticosteroids (CS), and immunomodulators, such as azathioprine (AZA) and 6-mercaptopurine (6-MP). However, a population-based cohort study in 1994 showed that with these treatment modalities, UC remained active in up to 50 % of patients throughout follow-up and approximately 20 % required colectomy. Furthermore, approximately 15 % of UC patients will have a severe UC attack requiring hospitalization during their illness and are treated primarily with high doses of intravenous (IV) CS. Despite IV CS, patients with severe attacks have a high colectomy rate varying from 38 to 47 %. In addition, cyclosporine A (CsA) has been validated as an efficacious treatment in acute severe IV steroid-refractory UC, but its use is frequently associated with toxicity and only seems to postpone an inevitable colectomy. In the past decade, agents directed against tumor necrosis factor (TNF) have been introduced successfully in the treatment of patients with moderate-to-severe and acute severe IV steroid-refractory UC.

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Authors and Affiliations

  1. Department of Gastroenterology, University Hospitals Leuven, Herestraat 49, Leuven, B3000, Belgium

    Marc Ferrante M.D., Ph.D., Séverine Vermeire M.D., Ph.D., Gert Van Assche M.D., Ph.D. & Paul Rutgeerts M.D., Ph.D., F.R.C.P.

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  1. Marc Ferrante M.D., Ph.D.
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  2. Séverine Vermeire M.D., Ph.D.
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  3. Gert Van Assche M.D., Ph.D.
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  4. Paul Rutgeerts M.D., Ph.D., F.R.C.P.
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Correspondence to Marc Ferrante M.D., Ph.D. .

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  1. Gastroenterology Division, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA

    Gary R. Lichtenstein

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Ferrante, M., Vermeire, S., Van Assche, G., Rutgeerts, P. (2014). Infliximab for Ulcerative Colitis. In: Lichtenstein, G. (eds) Medical Therapy of Ulcerative Colitis. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1677-1_15

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  • DOI: https://doi.org/10.1007/978-1-4939-1677-1_15

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