Recommendations for the treatment of ulcerative colitis with infliximab: A gastroenterology expert group consensus

Reinisch, Walter, Van Assche, Gert, Befrits, Ragnar, Connell, William, D'Haens, Geert, Ghosh, Subrata, Michetti, Pierre, Ochsenkuhn, Thomas, Panaccione, Remo, Schreiber, Stefan, Silverberg, Mark S., Sorrentino, Dario, van der Woude, Janneke, Vermeire, Séverine and Panes, Julian (2012) Recommendations for the treatment of ulcerative colitis with infliximab: A gastroenterology expert group consensus. Journal of Crohns and Colitis, 6 2: 248-258. doi:10.1016/j.crohns.2011.11.001


Author Reinisch, Walter
Van Assche, Gert
Befrits, Ragnar
Connell, William
D'Haens, Geert
Ghosh, Subrata
Michetti, Pierre
Ochsenkuhn, Thomas
Panaccione, Remo
Schreiber, Stefan
Silverberg, Mark S.
Sorrentino, Dario
van der Woude, Janneke
Vermeire, Séverine
Panes, Julian
Total Author Count Override 15
Title Recommendations for the treatment of ulcerative colitis with infliximab: A gastroenterology expert group consensus
Journal name Journal of Crohns and Colitis   Check publisher's open access policy
ISSN 1873-9946
1876-4479
Publication date 2012-03
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1016/j.crohns.2011.11.001
Volume 6
Issue 2
Start page 248
End page 258
Total pages 11
Place of publication Amsterdam, Netherlands
Publisher Elsevier
Collection year 2013
Language eng
Formatted abstract
Background and aims:
Infliximab is currently the only biologic approved for treatment of adults with moderate to severe, active ulcerative colitis (UC) unresponsive to conventional therapies. It rapidly controls symptoms, induces and sustains steroid-free remission, stimulates mucosal healing, and reduces serious complications. Although infliximab tends to be reserved for patients with severe disease, it may be even more beneficial for moderate disease earlier in the disease course. Therefore, it is important to identify which patients are candidates for infliximab therapy.

Methods:
A collaborative Delphi survey was used to obtain consensus on use of biologic therapy in patients with UC from an expert panel of 12 gastroenterologists with substantial experience using infliximab in clinical practice and clinical trials. The panel also addressed issues that influence the use of infliximab in UC, including its potential as an alternative to surgery.

Results:
The panel agreed that: (1) it is necessary to adopt additional treatment goals beyond symptom control, i.e., complete mucosal healing, steroid-free remission, improved QoL, and reduced long-term complications; (2) it may be possible to achieve these treatment goals with infliximab, especially if it is used earlier in the course of UC; and (3) infliximab should be offered as an alternative to surgery in patients being considered for colectomy. The panel also agreed on factors for identifying candidates for infliximab therapy (e.g., persistently active UC, steroid-dependent/refractory disease, and high C-reactive protein).

Conclusions:
This consensus statement provides useful and practical information on how to achieve evolving treatment goals with infliximab in moderate to severe UC.
Keyword Ulcerative colitis
Treatment
Consensus
Colectomy
TNF inhibitor
Biologic
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Available online 10 January 2012.

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2013 Collection
School of Medicine Publications
 
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