Antibody treatment for ulcerative colitis reduces need for colon
29 October 2009
Ulcerative colitis patients had a 41% reduction in removal of
their colon (colectomy) after a year when treated with the artificial
antibody infliximab, according to a study led by Mayo Clinic and
published in the October 2009 issue of Gastroenterology.
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 lead author of the
study. "We found that treatment with infliximab reduced the need for
colectomy by 41 percent compared 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
The research showed that treatment with infliximab at 0, 2 and 6 and
then every 8 weeks reduced the incidence of colectomy through 54 weeks
by 41 percent in outpatients with moderately-to-severe active ulcerative
The cumulative incidence 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 therapy.
"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 treatment solutions for patients beyond surgery."
Previous research has shown that infliximab therapy 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 (TNFA). TNFA is a chemical messenger and a key
part of the immune reaction. Infliximab blocks the action of TNFA by
preventing it from binding to its receptor in the cell.
Ulcerative colitis usually affects only the inner lining of the large
intestine (colon) and rectum. It usually 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