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- Title
Intravenous tacrolimus is a superior induction therapy for acute severe ulcerative colitis compared to oral tacrolimus.
- Authors
Shimizu, Hiromichi; Fujii, Toshimitsu; Kinoshita, Kenji; Kawamoto, Ami; Hibiya, Shuji; Takenaka, Kento; Saito, Eiko; Nagahori, Masakazu; Ohtsuka, Kazuo; Watanabe, Mamoru; Okamoto, Ryuichi
- Abstract
<bold>Background: </bold>Intravenous corticosteroid is the mainstay for managing acute severe ulcerative colitis, but one-third of patients do not respond to intravenous corticosteroid. Tacrolimus, a salvage therapy before colectomy, is usually orally administered, though its bioavailability is low compared intravenous administration. The efficacy of intravenous tacrolimus has not been widely studied.<bold>Aim: </bold>To determine the efficacy and safety of intravenous tacrolimus for the treatment of acute severe ulcerative colitis.<bold>Methods: </bold>Eighty-seven hospitalized acute severe ulcerative colitis patients were enrolled for a prospective cohort study between 2009 and 2017. Sixty-five patients received intravenous tacrolimus and 22 received oral tacrolimus. The primary outcome was the achievement of clinical remission within 2 weeks. Relapse and colectomy incidence and adverse events were assessed at 24 weeks.<bold>Results: </bold>Response rates of both treatments exceeded 50% but were not significantly different. The remission rate was higher in intravenous tacrolimus compared with oral tacrolimus. At 24 weeks, oral and intravenous tacrolimus showed similar relapse-free survival rates; however, colectomy-free survival rates were higher in intravenous tacrolimus compared with oral tacrolimus.<bold>Conclusions: </bold>Patients receiving intravenous tacrolimus achieved superior remission and colectomy-free survival rates compared with patients receiving oral tacrolimus. Safety was similar between the two treatments.
- Subjects
ULCERATIVE colitis; TACROLIMUS; INTRAVENOUS therapy; SALVAGE therapy; SURVIVAL rate
- Publication
BMC Gastroenterology, 2021, Vol 21, Issue 1, p1
- ISSN
1471-230X
- Publication type
journal article
- DOI
10.1186/s12876-021-02043-6