330 - Combination Therapy of Cyclosporine and Vedolizumab is Effective and Safe for Severe, Steroid-Resistant Ulcerative Colitis Patients: A Prospective Study

Tarabar, Dino; Jurdi, Katia El; Yvellez, Olivia; Milenković, Zoran; Petrović, Stanko; Subotić, Bojana; Brocic, Tanja; Brcerevic, Irina; Latinovic, Olgica; Rubin, David T.

doi:10.1016/s0016-5085(18)30725-x

Cited by 2 publications

(3 citation statements)

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“…Induction therapy with CNIs may show clinical effectiveness in patients with steroid-refractory acute severe UC, followed by vedolizumab as maintenance treatment. 48 CNIs might therefore be a potential alternative treatment to corticosteroids, if these would later appear to have more detrimental than beneficial effects in patients with active IBD and COVID-19.…”

Section: Discussionmentioning

confidence: 99%

Treatment of severe acute ulcerative colitis in SARS-CoV-2 infected patients: report of three cases and discussion of treatment options

Bourgonje

Linschoten

West

et al. 2021

Therap Adv Gastroenterol

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In the wake of the coronavirus disease 2019 (COVID-19) pandemic, it is unclear how asymptomatic severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-infected patients who present with acute severe ulcerative colitis (UC) can be treated effectively and safely. Standard treatment regimens consist of steroids, immunomodulatory drugs, and biological therapies, but therapeutic decision-making becomes challenging as there are uncertainties about how to deal with these drugs in patients with COVID-19 and active UC. Importantly, guidelines for this particular group of patients with UC are still lacking. To inform therapeutic decision-making, we describe three consecutive cases of patients with active UC and COVID-19 and discuss their treatments based on theoretical knowledge, currently available evidence and clinical observations. Three patients were identified through our national inflammatory bowel disease network [Initiative on Crohn’s and Colitis (ICC)] for whom diagnosis of SARS-CoV-2-infection was established by reverse transcription–polymerase chain reaction (RT-PCR) testing in nasopharynx, stools, and/or biopsies. Acute severe UC was diagnosed by clinical parameters, endoscopy, and histopathology. Clinical guidelines for SARS-CoV-2-negative patients advocate the use of steroids, calcineurin inhibitors, or tumor necrosis factor alpha (TNF-α)-antagonists as induction therapy, and experiences from the current three cases show that steroids and TNF-α-antagonists could also be used in patients with COVID-19. This could potentially be followed by TNF-α-antagonists, vedolizumab, or ustekinumab as maintenance therapy in these patients. Future research is warranted to investigate if, and which, immunomodulatory drugs should be used for COVID-19 patients that present with active UC. To answer this question, it is of utmost importance that future cases of patients with UC and COVID-19 are documented carefully in international registries, such as the SECURE-IBD registry.

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Section: Discussionmentioning

confidence: 99%

Treatment of severe acute ulcerative colitis in SARS-CoV-2 infected patients: report of three cases and discussion of treatment options

Bourgonje

Linschoten

West

et al. 2021

Therap Adv Gastroenterol

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“…Historically, thiopurines like azathioprine or mercaptopurine have been used for this purpose because they are effective for the treatment of UC but may require months to have a full therapeutic effect. There have been promising reports of using vedolizumab similarly 66,67 . Vedolizumab is a monoclonal antibody that selectively blocks lymphocyte trafficking to the gut that, like thiopurines, has an onset of action that is significantly longer than calcineurin and TNF inhibitors.…”

Section: Rescue Therapy For Steroid‐refractory Diseasementioning

confidence: 99%

“…There have been promising reports of using vedolizumab similarly. 66,67 Vedolizumab is a monoclonal antibody that selectively blocks lymphocyte trafficking to the gut that, like thiopurines, has an onset of action that is significantly longer than calcineurin and TNF inhibitors.…”

Section: Cyclosporinementioning

confidence: 99%

Inpatient Management of Acute Severe Ulcerative Colitis

Fudman

Sattler

Feuerstein

2019

Journal of Hospital Medicine

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Acute severe ulcerative colitis (ASUC) is a potentially lifethreatening presentation of ulcerative colitis that in nearly all cases requires inpatient management and coordinated care from hospitalists, gastroenterologists, and surgeons. Even with ideal care, a substantial proportion of patients will ultimately require colectomy, but most patients can avoid surgery with intravenous corticosteroid treatment and if needed, appropriate rescue therapy with infliximab or cyclosporine. In-hospital management requires not only therapies to reduce the inflammation at the heart of the disease process, but also to avoid complications of the disease and its treatment. Care for ASUC must be anticipatory, with patient education and evaluation starting at the time of admission in advance of the possible need for urgent medical or surgical rescue therapy. Here we outline a general approach to the treatment of patients hospitalized with ASUC, highlighting the common pitfalls and critical points in management.

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330 - Combination Therapy of Cyclosporine and Vedolizumab is Effective and Safe for Severe, Steroid-Resistant Ulcerative Colitis Patients: A Prospective Study

Cited by 2 publications

References 0 publications

Treatment of severe acute ulcerative colitis in SARS-CoV-2 infected patients: report of three cases and discussion of treatment options

Treatment of severe acute ulcerative colitis in SARS-CoV-2 infected patients: report of three cases and discussion of treatment options

Inpatient Management of Acute Severe Ulcerative Colitis

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