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Evidence summaries

Tumour Necrosis Factor Alpha Blocking Agents (Infliximab) for Induction of Remission in Ulcerative Colitis

In patients with moderate to severe ulcerative colitis refractory to conventional treatment infliximab is effective in inducing clinical remission, inducing clinical response, promoting mucosal healing, and reducing the need for colectomy at least in the short term. Level of evidence: "A"

A Cochrane review [Abstract] 1 included 7 studies with a total of 860 subjects. In patients with moderate to severe ulcerative colitis whose disease was refractory to conventional treatment using corticosteroids and/or immunosuppressive agents, infliximab (three intravenous infusions at 0, 2, and 6 weeks) was more effective than placebo in inducing clinical remission (RR 3.22, 95% CI 2.18 to 4.76); inducing endoscopic remission (RR 1.88, 95% CI 1.54 to 2.28); and in inducing clinical response (RR 1.99, 95% CI 1.65 to 2.41) at 8 weeks. A single infusion of infliximab was also more effective than placebo in reducing the need for colectomy within 90 days after infusion (RR 0.44, 95% CI 0.22 to 0.87).

    References

    • Lawson MM, Thomas AG, Akobeng AK. Tumour necrosis factor alpha blocking agents for induction of remission in ulcerative colitis. Cochrane Database Syst Rev 2006 Jul 19;3:CD005112. [PubMed]

Primary/Secondary Keywords