Impact of Infliximab and Cyclosporine on the Risk of Colectomy in Hospitalized Patients with Ulcerative Colitis Complicated by Cytomegalovirus - A Multicenter Retrospective Study

Uri Kopylov, Konstantinos Papamichael, Konstantinos Katsanos, Matti Waterman, Ariella Bar-Gil Shitrit, Trine Boysen, Francisco Portela, Armando Peixoto, Andrew Szilagyi, Marco Silva, Giovanni MacOni, Ofir Har-Noy, Peter Bossuyt, Gerassimos Mantzaris, Manuel Barreiro De Acosta, Maria Chaparro, Dimitrios K. Christodoulou, Rami Eliakim, Jean Francois Rahier, Fernando MagroDavid Drobne, Marc Ferrante, Elena Sonnenberg, Britte Siegmund, Vinciane Muls, Tamara Thurm, Henit Yanai, Iris Dotan, Tim Raine, Avi Levin, Eran Israeli, Fahd Ghalim, Franck Carbonnel, Severine Vermeire, Shomron Ben-Horin, Xavier Roblin

Research output: Contribution to journalArticlepeer-review

27 Scopus citations

Abstract

Background: Cytomegalovirus (CMV) is frequently detected in patients with ulcerative colitis (UC). The impact of CMV infection on the outcome of UC exacerbation remains unclear. The benefit of combining antiviral with anti-inflammatory treatment has not been evaluated yet. The aim of this study was to compare the outcome of CMV-positive hospitalized patients with UC treated with antiviral therapy either alone or combined with salvage anti-inflammatory therapy (infliximab [IFX] or cyclosporine A [CsA]). Methods: This was a multicenter retrospective study of hospitalized CMV-positive patients with UC. The patients were classified into 2 groups: antiviral - if treated with antivirals alone; combined - if treated with both antiviral and anti-inflammatory therapy. The outcomes included the rate of colectomy in both arms during the course of hospitalization and after 3/12 months. Results: A total of 110 patients were included; 47 (42.7%) patients did not receive IFX nor CsA; 36 (32.7%) received IFX during hospitalization or within 1 month before hospitalization; 20 (18.1%) patients received CsA during hospitalization; 7 (6.4%) were exposed to both IFX and CsA. The rate of colectomy was 14.5% at 30 days, 20.0% at 3 months, and 34.8% at 12 months. Colectomy rates were similar across treatment groups. No clinical and demographic variables were independently associated with the risk of colectomy. Conclusions: IFX or cyclosporine therapy is not associated with additional risk for colectomy over antiviral therapy alone in hospitalized CMV-positive patients with UC.

Original languageEnglish
Pages (from-to)1605-1613
Number of pages9
JournalInflammatory Bowel Diseases
Volume23
Issue number9
DOIs
StatePublished - 1 Sep 2017
Externally publishedYes

Keywords

  • cyclosporine
  • cytomegalovirus
  • infliximab
  • ulcerative colitis

ASJC Scopus subject areas

  • Immunology and Allergy
  • Gastroenterology

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