title: Promising effect of infliximab on the extent of involvement in ulcerative colitis.
abstract: BACKGROUND
  Ulcerative colitis (UC) is a disabling disease with increasing incidence in Iran. In spite of combined medical therapy, some patients eventually undergo total colectomy. Infliximab has proved itself as a rescue therapy and even as an early aggressive therapy for severe extensive UC. Meantime, there are concerns about its complications. The aim of this study was to evaluate the efficacy of infliximab in Iranian refractory UC patients.
  
  
  METHODS
  This multi centric case-series study included 29 UC patients receiving two to three of the drugs prednisolone, AZT/6MP and 5ASA but yet having flare-ups. At first, the extent of colon involvement was determined by colonoscopy; then the drug was administered at baseline, 2nd week and 6th week and colonoscopy repeated afterwards. Clinical and laboratory data were also recorded.
  
  
  RESULTS
  In first endoscopy 18 patients (62%) out of 29 suffered from pancolitis and none had normal results. In second examination (done on 19 patients), one was normal and only 8 of 18 (27.6%) had pancolitis. Considering missing cases, at least in 33.3% of patients the drug has reduced the extreme extent of colon involvement. Also a wilcoxon signed ranks test revealed significant reduction of the disease extension after this treatment (p = 0.008). There were only one leucopenic and one hypotensive reactions in short term. The drug showed effectiveness in the term of disease modifying, too.
  
  
  CONCLUSIONS
  These data show the usefulness of the drug in refractory UC. Longer follow ups and controlled trials are needed.
authors: Associate Professor, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Peyman
authors: P
authors: Adibi
authors: Pejman
authors: P
authors: Mollakhalili
authors: Zahra
authors: Z
authors: Fallah
authors: Nasser Ebrahimi
authors: NE
authors: Daryani
authors: Hossein
authors: H
authors: Ajdarkosh
authors: Hossein
authors: H
authors: Khedmat
authors: Faramarz
authors: F
authors: Derakhshan
authors: Ashraf
authors: A
authors: Karbassi
authors: Mahshid
authors: M
authors: Ashkzari
authors: Hamid
authors: H
authors: Tavakkoli