Effectiveness of tacrolimus therapy in refractory ulcerative colitis compared to infliximab with propensity score matching
2024

Comparing Tacrolimus and Infliximab for Ulcerative Colitis Treatment

Sample size: 241 publication 10 minutes Evidence: moderate

Author Information

Author(s): Yoshihara Takeo, Amano Takahiro, Shinzaki Shinichiro, Tsujii Yuri, Asakura Akiko, Tashiro Taku, Tani Mizuki, Otake-Kasamoto Yuriko, Yamada Takuya, Sakakibara Yuko, Osugi Naoto, Ishii Shuji, Egawa Satoshi, Araki Manabu, Arimoto Yuki, Nakahara Masanori, Murayama Yoko, Kobayashi Ichizo, Kinoshita Kazuo, Ogawa Hiroyuki, Hiyama Satoshi, Shibukawa Narihiro, Komori Masato, Okuda Yorihide, Kizu Takashi, Kitamura Tetsuhisa, Kato Minoru, Tsujii Yoshiki, Inoue Takahiro, Iijima Hideki, Hayashi Yoshito, Takehara Tetsuo

Primary Institution: Osaka University Graduate School of Medicine

Hypothesis

Is tacrolimus more effective than infliximab for inducing remission in refractory ulcerative colitis?

Conclusion

Tacrolimus therapy resulted in a higher rate of clinical remission compared to infliximab, but it also led to a higher rate of colectomy during maintenance treatment.

Supporting Evidence

  • The proportion of clinical remission at week 8 was 65.2% in the tacrolimus group compared to 37.3% in the infliximab group.
  • The long-term colectomy-free rate was lower in the tacrolimus group than in the infliximab group.
  • Serum albumin level ≤ 3.5 g/dL at week 8 was identified as a predictor for colectomy after tacrolimus induction.

Takeaway

This study looked at two medicines for treating a gut disease called ulcerative colitis. One medicine, tacrolimus, helped more people feel better quickly, but it also made some people need surgery later.

Methodology

A multi-institutional retrospective study comparing tacrolimus and infliximab in patients with refractory ulcerative colitis using propensity score matching.

Potential Biases

Selection bias due to the retrospective nature of the study.

Limitations

The study is retrospective, which may introduce selection bias, and it could not adjust for unmeasured confounders.

Participant Demographics

Patients aged at least 16 years with refractory ulcerative colitis treated between January 2010 and March 2019.

Statistical Information

P-Value

0.0016

Confidence Interval

95% CI, 1.02–6.50

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1038/s41598-024-77365-y

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