Infliximab reduces need for surgery in ulcerative colitits

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A newly released study led by Mayo Clinic scientists has observed that ulcerative colitis patients had a 41 percent reduction in colectomy after a year when treated with infliximab, as per a research studyreported in the October 2009 issue of Gastroenterology.

Typically ulcerative colitis, an inflammatory bowel disease (ibd) that causes chronic inflammation of the colon, is characterized by abdominal pain and diarrhea. Like Crohn's disease, another common IBD, ulcerative colitis can be debilitating and often lead to colectomy or surgical removal of the colon.

"Our purpose in this study was to see if the use of infliximab for ulcerative colitis would reduce the need for surgery," says William Sandborn, M.D., a Mayo Clinic gastroenterologist and main author of the study. "We observed that therapy with infliximab reduced the need for colectomy by 41 percent in comparison to patients treated with placebo."

In this multi-center, international study, 728 patients received placebo or infliximab (5 or 10 mg/kg) for 46 weeks and were monitored for hospitalization or surgical outcomes. Eighty-seven percent (630 of 728) had complete follow-up for the endpoint of whether or not they had colectomy, while the remaining 13 percent (98 of 728) of patients had follow-up for less then a year, with a median follow-up of 6.2 months in these patients. The research showed that therapy with infliximab at 0, 2 and 6 and then every 8 weeks reduced the occurence rate of colectomy through 54 weeks by 41 percent in outpatients with moderately-to-severe active ulcerative colitis.

The cumulative occurence rate of colectomy through 54 weeks was 10% for infliximab and 17% for placebo (p=0.02). Compared with placebo, fewer ulcerative colitis-related hospitalizations and surgeries/procedures occurred with infliximab treatment.

"One of the most feared outcomes for ulcerative colitis patients is surgical removal of the colon," says Dr. Sandborn. "Our research hopes to provide other therapy solutions for patients beyond surgery."

Prior research has shown that infliximab treatment induced clinical remission and bowel healing for colitis patients. This new research provides more information and options for patients struggling with this difficult disease, explains Dr. Sandborn.

Infliximab is an artificial antibody that works by blocking tumour necrosis factor alpha (TNF?). TNF? is a chemical messenger and a key part of the immune reaction. Infliximab blocks the action of TNF? by preventing it from binding to its receptor in the cell.

Ulcerative colitis commonly affects only the inner lining of the large intestine (colon) and rectum. It commonly occurs in a continuous stretch of the colon, unlike Crohn's disease, which occurs in patches anywhere in the digestive tract and often spreads into the deeper layers of affected tissues.

Each year, Mayo Clinic physicians treat more than 2,000 people with ulcerative colitis. Read more information on therapy for ulcerative colitis at Mayo Clinic.

Mayo Clinic's Division of Gastroenterology and Hepatology has been ranked #1 in the U.S. News & World Report Honor Roll of Top Hospitals since the rankings began 20 years ago.

Dr. Sandborn provided consulting services for Centocor during the course of this research and received no personal compensation. Mayo Clinic received reimbursement for the services provided by Dr. Sandborn.


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