Jeanne Tung, M.D., discusses infliximab for patients with severe ulcerative colitis. Specifically, Dr. Tung focuses on a recent study published in Clinical Gastroenterology and Hepatology that studied using an accelerated schedule compared to the usual dosing schedule of 6 weeks.
Infliximab, otherwise known as Remicade, was approved for Crohn's disease in 1997. Clinical trials demonstrated it could be useful for patients with moderate to severe ulcerative colitis. The typical dosing schedule for both Crohn's disease and ulcerative colitis is an induction schedule (0, 2, and 6 weeks) then switching to a maintenance schedule of every 8 weeks. However, in patients with severe ulcerative colitis, infliximab may not prevent surgery.
In the recent study published in Clinical Gastroenterology and Hepatology, researchers at St. Vincent's University Hospital in Ireland specifically looked at their experience using an accelerated scheduled (approximately 3 infusions within 24 days) compared to the usual 6 weeks schedule.
In both scenarios, patients who were able to avoid surgery went on to infusions every 8 weeks. All of the patients had been sick enough to receive IV steroids before starting infliximab.
Who did better?
The researchers didn't report whether there were adverse events, particularly related to infections.
This was a relatively small study but does suggest for doctors to consider giving infliximab more frequently than standard induction schedule for patients with severe ulcerative colitis.
Read the full study online here.
For more information about IBD, visit mayoclinic.org/IBD.
Dr. Tung is a pediatric gastroenterologist at Mayo Clinic.