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Single-centre experience with anti-tumour necrosis factor treatment in budesonide-refractory microscopic colitis patients
Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Gastroentorology.
Linköping University, Department of Clinical and Experimental Medicine, Divison of Neurobiology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Clinical pathology.
Region Östergötland, Heart and Medicine Center, Department of Gastroentorology.
2019 (English)In: United European Gastroenterology journal, ISSN 2050-6406, E-ISSN 2050-6414, article id UNSP 2050640619871750Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background: Microscopic colitis is an inflammatory bowel disease that causes chronic, watery diarrhoea. Microscopic colitis is usually effectively treated with budesonide, but some patients are refractory. Data on alternative treatments are sparse. Aims: The purpose of this study was to retrospectively evaluate outcome of microscopic colitis patients receiving anti-tumour necrosis factor therapy at our centre. Methods:Treatment results, including side effects, for all microscopic colitis patients receiving anti-tumour necrosis factor therapy were registered at week 12 and at end of follow-up. Clinical remission was defined as a mean of Results: The study cohort comprised 18 patients; mean age at diagnosis was 47 years (range 19-77). Ten and eight patients, respectively, received adalimumab and infliximab as first-line anti-tumour necrosis factor; seven patients received second-line anti-tumour necrosis factor due to non-response, loss of response or side effects. At week 12, 9/18 patients had achieved remission, 6/18 were responders and 3/18 were non-responders. Of the nine remission patients, 3/18 (16%) had long-lasting clinical remission post-induction therapy alone. Five patients (28%) (one first-line, four second-line anti-tumour necrosis factor) were in remission and one patient (6%) responded to maintenance treatment; follow-up was mean 22 (range 4-60) months. Six patients (33%) had minor, reversible side effects. Conclusions: Over half of budesonide-refractory microscopic colitis patients can achieve clinical remission or response on anti-tumour necrosis factor agents. Prospective studies are mandatory to evaluate the efficacy and safety of anti-tumour necrosis factor treatments in budesonide-refractory microscopic colitis.

Place, publisher, year, edition, pages
SAGE PUBLICATIONS INC , 2019. article id UNSP 2050640619871750
Keywords [en]
Microscopic colitis; biological treatment; budesonide refractory; collagenous colitis; lymphocytic colitis
National Category
Gastroenterology and Hepatology
Identifiers
URN: urn:nbn:se:liu:diva-160427DOI: 10.1177/2050640619871750ISI: 000483422900001OAI: oai:DiVA.org:liu-160427DiVA, id: diva2:1353436
Note

Funding Agencies|Region Ostergotland, Sweden; Medical Research Council of Southeast Sweden

Available from: 2019-09-23 Created: 2019-09-23 Last updated: 2019-09-23

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Daferera, NikiHjortswang, HenrikIgnatova, Simone
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Division of Neuro and Inflammation ScienceFaculty of Medicine and Health SciencesDivision of Cardiovascular MedicineDepartment of GastroentorologyDivison of NeurobiologyClinical pathology
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United European Gastroenterology journal
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