Certain patients with ulcerative colitis (UC) do not respond well to steroid treatment. These patients are considered to have steroid-refractory acute severe ulcerative colitis, or ASUC. Other therapeutic options, such as cyclosporine and infliximab, may be used to overcome treatment barriers and avoid colectomies. HCP Live details the results of a study which explored the short- and long-term safety and efficacy for both treatments as rescue agents for people with steroid-refractory acute severe UC. The study data, published in the Journal of Crohn’s and Colitis, found that cyclosporine showed stronger long-term efficacy than infliximab. Learn more about cyclosporine.

To begin their retrospective study, the research team explored data from 121 individuals with UC from a 10-year period. Of these, 2 individuals (1.65%) had a colectomy; the remaining 119 individuals (98.35%) received intravenously administered corticosteroids. Study findings show that:

• In relation to short-term efficacy, no statistically significant difference was discovered between infliximab and cyclosporine. 
• 55% of patients responded to corticosteroid treatment, while 45% did not. 37% of patients required rescue therapy. 
• 10.3% of people receiving cyclosporine later required a colectomy, as opposed to 12.5% of those receiving infliximab. Regarding people who did not require a colectomy, those taking infliximab were more likely to require hospitalization. 
• Both cyclosporine and infliximab were well-tolerated and safe for use. 

Ulcerative Colitis (UC): The Details

Both ulcerative colitis and Crohn’s disease exist under the greater umbrella of inflammatory bowel disease (IBD). Ulcerative colitis causes chronic inflammation, sores, and ulcers in the large intestine. An estimated 700,000 people in the U.S. have UC. The exact cause is unknown, though many hypothesize that UC results from immune dysfunction. Younger individuals and people over 60 years old, people with a family history of UC, and those of Jewish heritage are at a higher risk of developing UC. Symptoms may include:

• Loose and/or bloody stool
• Failure to thrive (in infants)
• Urgency to defecate that may be paired with inability to defecate
• Joint pain
• Fever
• Anemia (low red blood cell count)
• Unintentional weight loss
• Fatigue
• Nausea
• Abdominal pain and cramping

Treatment options for UC are varied and may include biologic medicines, immunomodulators, corticosteroids, aminosalicylates, antibiotics, or, in severe cases, surgery. Right now, no cures exist.