Authors: Kah Hoong Chang John P Burke J Calvin Coffey
Publish Date: 2012/11/01
Volume: 28, Issue: 3, Pages: 287-293
Abstract
Acute severe colitis affects 25 of patients with ulcerative colitis UC Up to 30–40 of these patients are resistant to intensive steroid therapy and therefore require rescue therapy to prevent emergent colectomy Data comparing rescue therapy using infliximab and cyclosporine are limited and equivocal This study evaluates the outcomes of UC patients receiving infliximab or cyclosporine as rescue therapy in acute severe steroidrefractory exacerbationsElectronic databases PubMed EMBASE and Cochrane database were searched for studies directly comparing infliximab and cyclosporine in UC and references of included studies were screened Two independent reviewers identified relevant studies and extracted data Metaanalyses were performed using the random effect model Outcome measures included 3 and 12month colectomy rates adverse drug reactions and postoperative complicationsSix retrospective cohort studies describing 321 patients met the inclusion criteria The metaanalysis did not show significant differences between infliximab and cyclosporine in the 3month colectomy rate odds ratio OR = 086 95 confidence interval CI = 031–241 p = 0775 in the 12month colectomy rate OR = 060 95 CI = 019–189 p = 0381 in adverse drug reactions OR = 076 95 CI = 034–170 p = 0508 and in postoperative complications OR = 166 95 CI = 026–1050 p = 0591 Funnel plot revealed no publication bias
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