Tacrolimus vs. anti‐tumour necrosis factor agents for moderately to severely active ulcerative colitis: a retrospective observational study

Yamamoto, Takayuki; Shimoyama, T; Umegae, Satoru; Matsumoto, Koichí

doi:10.1111/apt.13531

Cited by 46 publications

(66 citation statements)

References 21 publications

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“…Yamamoto et al [9] have reported that for 100 patients with moderate to severe UC, the clinical remission rate after 12 weeks was 28% and 40% in the anti-TNF agents and Tac groups, respectively. Serum albumin and CRP levels at baseline were not statistically different between groups.…”

Section: Discussionmentioning

confidence: 99%

“…No differences between the groups were found in clinical disease activity using the partial Mayo score. The median partial Mayo score at base line was 7 (IQR, 6-7) in the IFX group vs. 6 (IQR, [3][4][5][6][7][8][9] in the Tac group (P = 0.600). In the laboratory data, hemoglobin was not different between the groups; however, the WBC, serum albumin and CRP were different.…”

Section: Baseline Characteristicsmentioning

confidence: 99%

“…Tacrolimus (Tac), a calcineurin inhibitor that has a mechanism of action similar to CsA, also has therapeutic efficacy for moderate to severe UC [7,8]. Several retrospective studies showed IFX and Tac had equal efficacy for moderate to severe UC [9][10][11]. These studies were retrospective and therefore the background characteristics of the patients were not randomized.…”

Section: Introductionmentioning

confidence: 99%

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A comparison of short-term therapeutic efficacy between infliximab and tacrolimus for moderate to severe ulcerative colitis

Yamagami

Nagami

et al. 2017

Romanian Journal of Internal Medicine

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Introduction. Both infliximab (IFX) and tacrolimus (Tac) are effective for inducing clinical remission in patients with ulcerative colitis (UC). However, no randomized study has addressed the relative efficacies of IFX and Tac for patients with moderate to severe UC. This study aimed to conduct a retrospective study on the relative efficacy of IFX and Tac in patients with moderate to severe UC, using an inverse probability of treatment weighting (IPTW) technique to adjust background factors statistically.Methods. Between July 2009 and March 2016, data obtained from 122 patients with moderate to severe UC who were treated with either IFX (n = 58) or Tac (n = 64) were analyzed retrospectively. We compared the short-term therapeutic efficacy between the IFX group and Tac group using IPTW technique.Results. The clinical remission rate at 14 weeks after treatment was 37.9% (22/58) in the IFX group and 50% (32/64) in the Tac group, respectively. The efficacy of IFX and Tac for clinical remission rate was not different according to univariate (Odds ratio [OR] 1.64, 95% confidence interval [CI] 0.80-3.37 P = 0.18) and multivariate analyses (OR 2.19, 95% CI 0.85-5.61, P = 0.10). After the background and confounders factors were adjusted by using IPTW based on propensity score, the efficacy of IFX and Tac for clinical remission rate was not differed statistically (OR, 1.483; 95% CI, 0.581-3.785; P = 0.409) Conclusion. IFX and Tac have equivalent short-term efficacies for induction in patients with moderate to severe UC.

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Section: Discussionmentioning

confidence: 99%

Section: Baseline Characteristicsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A comparison of short-term therapeutic efficacy between infliximab and tacrolimus for moderate to severe ulcerative colitis

Yamagami

Nagami

et al. 2017

Romanian Journal of Internal Medicine

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“…Figure 1 shows the flow diagram which describes the reasons for citations exclusion. Finally, 22 studies (4)(5)(6)(9)(10)(11)(12)(13)(14)(15)(16)(17)(20)(21)(22)(23)(24)(25)28,30,32,33) that fulfilled eligibility criteria were included. Only two studies were randomized controlled trials (24,25) (Ogata 2006 and Ogata 2012); these were included for meta-analysis.…”

Section: Resultsmentioning

confidence: 99%

“…During the last few years, there has been a significant development of scientific evidence showing the benefit of biological therapy -mainly anti-TNF α agents -in both scenarios (7) . Nevertheless, approximately 30% of patients with moderateto-severe disease, whether they are CD or UC patients, do not respond to anti-TNF α therapy (primary failure) (3) and a significant proportion of patients (13% to 25% per year of treatment) may develop resistance and hence loss of efficacy to this type of treatment (secondary failure) (27,33) . This is why alternative therapeutic strategies are needed for these patients so that clinical conditions are improved and potentially serious complications can be avoided.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Tacrolimus for Induction of Remission in Patients With Moderate-to-Severe Ulcerative Colitis: A Systematic Review and Meta-Analysis

Lasa

Olivera

2017

Arq. Gastroenterol.

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-Background -There is evidence that shows that calcineurin inhibitors may be useful for the treatment of severe ulcerative colitis. However, evidence regarding the efficacy of tacrolimus for remission induction in this setting is scarce. Objective -To develop a systematic review on the existing evidence regarding the clinical efficacy of tacrolimus for the induction of remission in patients with moderate-to-severe ulcerative colitis. Methods -A literature search was undertaken from 1966 to August 2016 using MEDLINE, Embase, LILACS and the Cochrane Library. The following MeSH terms were used: "Inflammatory Bowel Diseases" or "Ulcerative Colitis" and "Calcineurin Inhibitors" or "Tacrolimus" or "FK506". Studies performed in adult ulcerative colitis patients that evaluated the clinical efficacy of tacrolimus for the induction of remission were considered for revision. A meta-analysis was performed with those included studies that were also placebo-controlled and randomized. Clinical response as well as clinical remission and mucosal healing were evaluated. Results -Overall, 755 references were identified, from which 22 studies were finally included. Only two of them were randomized, placebo-controlled trials. A total of 172 patients were evaluated. A significantly lower risk of failure in clinical response was found for tacrolimus versus placebo ]; moreover, a lower risk of failure in the induction of remission was also found versus placebo ]. Conclusion -Tacrolimus seems to be a valid therapeutic alternative for the induction of remission in patients with moderate-to-severe ulcerative colitis. HEADINGS -Inflammatory bowel diseases. Tacrolimus. Calcineurin inhibitors.

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The efficacy of maintenance therapy after remission induction with tacrolimus in ulcerative colitis with and without previous tumor necrosis factor‐α inhibitor

et al. 2019

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Background and Aim Tacrolimus (TAC) is an important therapeutic option for remission induction in patients with refractory ulcerative colitis (UC). However, there is little evidence available on long‐term outcomes and maintenance treatments after TAC therapy, especially in cases with previous tumor necrosis factor‐α (TNF‐α) inhibitor therapy. Methods Long‐term outcomes and remission induction after TAC treatment were retrospectively examined in refractory UC patients with and without previous TNF‐α inhibitor therapy. Results The mean disease activity index and the endoscopic activity index scores decreased significantly during the 12‐week treatment after TAC therapy in both groups, showing a significantly greater decrease in the group without TNF‐α inhibitor therapy than in the group with previous TNF‐α inhibitor therapy. One year or more after TAC therapy, TNF‐α inhibitor and/or azathioprine was used as maintenance therapy in most cases in the group without previous TNF‐α inhibitor treatment, while azathioprine was primarily used in the group with previous TNF‐α inhibitor treatment. Colectomy was performed in 45.5% (5/11) and 15.6% (7/45) of the groups with and without previous TNF‐α inhibitor therapy, respectively, and the group without previous TNF‐α inhibitor treatment had a better colectomy‐free rate than the group with previous TNF‐α inhibitor treatment after TAC therapy on Kaplan–Meier analysis. Conclusions TAC is effective for remission induction in refractory UC patients with and without previous TNF‐α inhibitor treatment. Maintenance medication after TAC therapy is an issue for the future, especially in UC cases with previous TNF‐α inhibitor treatment failure.

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Tacrolimus vs. anti‐tumour necrosis factor agents for moderately to severely active ulcerative colitis: a retrospective observational study

Abstract: SUMMARY BackgroundThere have been no comparative studies of tacrolimus vs. anti-tumour necrosis factor (anti-TNF) agents to determine which treatment is safer or more effective in refractory ulcerative colitis (UC).

Cited by 46 publications

References 21 publications

A comparison of short-term therapeutic efficacy between infliximab and tacrolimus for moderate to severe ulcerative colitis

A comparison of short-term therapeutic efficacy between infliximab and tacrolimus for moderate to severe ulcerative colitis

Efficacy of Tacrolimus for Induction of Remission in Patients With Moderate-to-Severe Ulcerative Colitis: A Systematic Review and Meta-Analysis

The efficacy of maintenance therapy after remission induction with tacrolimus in ulcerative colitis with and without previous tumor necrosis factor‐α inhibitor

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