title: Treatment of acute ulcerative colitis with infliximab, a retrospective study from three Danish hospitals.
abstract: BACKGROUND
  In acute steroid-refractory ulcerative colitis, rescue therapy with infliximab has become a therapeutic option in patients facing colectomy. Data on efficacy and safety in this setting are sparse.
  
  
  METHODS
  Patients with ulcerative colitis and acute and severe steroid-refractory disease, who were given infliximab as rescue therapy, were identified by a review of patients' records and databases of infliximab-treated patients. Data on patient background, concomitant medication, endoscopic and laboratory results, clinical activity and adverse events were collected.
  
  
  RESULTS
  Fifty-six patients, all admitted because of high disease activity of short duration, and failing high-dose glucocorticoid treatment, received infliximab treatment and were followed up for a median of 538 days (range 2-1769). Colectomy was avoided in 61% of cases. No fatalities were observed. Concomitant medication at the end of follow-up indicated a low number of relapses in patients without colectomies.
  
  
  CONCLUSIONS
  Our results show a lasting benefit of infliximab rescue therapy in 61% of patients with acute, steroid-refractory ulcerative colitis, a low incidence of late colectomies, and low frequency of steroid use in patients who avoided colectomy. High levels of C-reactive protein on admittance and at the first infliximab infusion were associated with colectomy. Our study adds to the growing experience of infliximab treatment of patients with acute, steroid-refractory ulcerative colitis.
authors.affiliation: Hvidovre University Hospital, Department of Gastroenterology, Kettegård Allé 30, 2650 Hvidovre, Denmark. c.o.mortensen@gmail.com
authors.forename: Christian
authors.initials: C
authors.lastname: Mortensen
authors.forename: Sarah
authors.initials: S
authors.lastname: Caspersen
authors.forename: Niels Lyhne
authors.initials: NL
authors.lastname: Christensen
authors.forename: Lise
authors.initials: L
authors.lastname: Svenningsen
authors.forename: Niels
authors.initials: N
authors.lastname: Thorsgaard
authors.forename: Lisbet Ambrosius
authors.initials: LA
authors.lastname: Christensen
authors.forename: Flemming
authors.initials: F
authors.lastname: Bendtsen
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D003082:Colectomy; D003093:Colitis, Ulcerative / Q000188:drug therapy* / Q000601:surgery; D003718:Denmark; D005260:Female; D006801:Humans; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D000069285:Infliximab