Tacrolimus therapy in moderate to subacute ulcerative proctocolitis: a large single-centre cohort study

Saifuddin, Aamir; Harris, Adam

doi:10.1136/flgastro-2017-100888

Cited by 6 publications

(2 citation statements)

References 15 publications

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“…However, there are some cases in which colectomy is unavoidable due to ineffective treatment with tacrolimus. Approximately 6.1%-66.7% patients who were treated with tacrolimus underwent colectomy[ 6 - 8 , 20 - 26 ]. Therefore, the possibility of performing colectomy in the future should be considered, especially when starting treatment with tacrolimus for patients with very severe UC.…”

Section: Discussionmentioning

confidence: 99%

“…In our study, 17 of 47 patients had clinical failure during a 3-mo follow-up, and the remission rate was 63.8%. Although there are differences in the observation period and the severity of enrolled patients, previous reports of the effects of tacrolimus on UC have reported a remission rate ranging from 9.4-75.6%[ 4 - 8 , 21 - 26 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

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Early serum albumin changes in patients with ulcerative colitis treated with tacrolimus will predict clinical outcome

Ishida¹,

Miyazu²,

Tamura³

et al. 2021

WJG

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BACKGROUND Oral tacrolimus is a therapeutic agent for moderate to severe steroid-dependent or resistant ulcerative colitis (UC), but remission induction is difficult, and it is necessary to treat the patient while considering the next treatment. AIM To examine serum albumin (Alb) level as a prognostic factor for the therapeutic effect of tacrolimus in clinical practice. METHODS Forty-seven patients with UC treated with tacrolimus at our institution were divided into remission and failure groups (colectomy or switch to biologics), and the biological data at the start of observation and at weeks 1 and 2 were retrospectively examined. Kaplan-Meier and multivariate analyses were performed using Alb as a prognostic factor in UC treatment. RESULTS During the three months observed, 17 (36.2%) patients failed treatment with tacrolimus. A comparison between the failure and remission groups showed a significant difference only in Alb in week 2, and in the week 2/week 0 Alb ratio, which showed the rate of change in Alb. The cut-off value of the week 2/week 0 Alb ratio that predicted failure was 1, and its area under the curve was 0.751 (95%CI: 0.604-0.898). In the Kaplan-Meier analysis, a week 2/week 0 Alb ratio ≤ 1 had a significantly higher failure rate than that of > 1; Cox proportional hazard regression analysis also showed that a week 2/week 0 Alb ratio ≤ 1 was an independent prognostic factor for failure within 3 mo after the start of tacrolimus treatment. CONCLUSION A week 2/week 0 Alb ratio ≤ 1 predicts failure within 3 mo of tacrolimus administration for UC. High failure risk exists with week 2 Alb values ≤ 1 on admission.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Early serum albumin changes in patients with ulcerative colitis treated with tacrolimus will predict clinical outcome

Ishida¹,

Miyazu²,

Tamura³

et al. 2021

WJG

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Tacrolimus

2019

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Delivery of tacrolimus with cationic lipid-assisted nanoparticles for ulcerative colitis therapy

et al. 2018

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Oral drug delivery with nanoparticles has demonstrated great potential for drugs with poor bioavailability. Efficient delivery is possible by overcoming both the mucus and epithelial barrier of the gastrointestinal tract (GIT). Cationic lipid-assisted nanoparticles (CLANs), which are composed of amphiphilic block copolymers and cationic lipids, have been well studied and have been proved beneficial for drug delivery. In this study, CLANs prepared by poly(ethylene glycol)-block-poly(lactic acid) (PEG-b-PLA) and 1,2-dioleoyl-3-trimethylammonium-propanechloride (DOTAP) or N,N-bis(2-hydroxyethyl)-N-methyl-N-(2-cholesteryloxycarbonyl aminoethyl)ammoniumbromide (BHEM-Chol) were used for oral delivery of tacrolimus (FK506) for ulcerative colitis treatment. The average size of these nanoparticles is around 110 nm and the zeta-potential is 35 mV. These nanoparticles maintained their size in buffer solutions of pH 1.2 and 6.8, and slowly release the encapsulated drug. CLANs can be accumulated in the colon and transported through the epithelium in the colitis model by dextran sulfate sodium salt (DSS), leading to attenuation of DSS-induced colitis.

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Tacrolimus therapy in moderate to subacute ulcerative proctocolitis: a large single-centre cohort study

Abstract: In line with UK and European guidelines, tacrolimus can be beneficial for refractory UC. With appropriate monitoring, it appears treatment can be continued safely long term.

Cited by 6 publications

References 15 publications

Early serum albumin changes in patients with ulcerative colitis treated with tacrolimus will predict clinical outcome

Early serum albumin changes in patients with ulcerative colitis treated with tacrolimus will predict clinical outcome

Tacrolimus

Delivery of tacrolimus with cationic lipid-assisted nanoparticles for ulcerative colitis therapy

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