Effectiveness of tacrolimus therapy in refractory ulcerative colitis compared to infliximab with propensity score matching
Abstract There is insufficient evidence comparing the outcomes of tacrolimus-based remission induction therapy with infliximab in refractory ulcerative colitis (UC) and evidence regarding optimal strategies after tacrolimus-based remission induction therapy. We conducted a multi-institutional retros...
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Nature Portfolio
2025-01-01
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| author | Takeo Yoshihara Takahiro Amano Shinichiro Shinzaki Yuri Tsujii Akiko Asakura Taku Tashiro Mizuki Tani Yuriko Otake-Kasamoto Takuya Yamada Yuko Sakakibara Naoto Osugi Shuji Ishii Satoshi Egawa Manabu Araki Yuki Arimoto Masanori Nakahara Yoko Murayama Ichizo Kobayashi Kazuo Kinoshita Hiroyuki Ogawa Satoshi Hiyama Narihiro Shibukawa Masato Komori Yorihide Okuda Takashi Kizu Tetsuhisa Kitamura Minoru Kato Yoshiki Tsujii Takahiro Inoue Hideki Iijima Yoshito Hayashi Tetsuo Takehara |
| author_facet | Takeo Yoshihara Takahiro Amano Shinichiro Shinzaki Yuri Tsujii Akiko Asakura Taku Tashiro Mizuki Tani Yuriko Otake-Kasamoto Takuya Yamada Yuko Sakakibara Naoto Osugi Shuji Ishii Satoshi Egawa Manabu Araki Yuki Arimoto Masanori Nakahara Yoko Murayama Ichizo Kobayashi Kazuo Kinoshita Hiroyuki Ogawa Satoshi Hiyama Narihiro Shibukawa Masato Komori Yorihide Okuda Takashi Kizu Tetsuhisa Kitamura Minoru Kato Yoshiki Tsujii Takahiro Inoue Hideki Iijima Yoshito Hayashi Tetsuo Takehara |
| author_sort | Takeo Yoshihara |
| collection | DOAJ |
| description | Abstract There is insufficient evidence comparing the outcomes of tacrolimus-based remission induction therapy with infliximab in refractory ulcerative colitis (UC) and evidence regarding optimal strategies after tacrolimus-based remission induction therapy. We conducted a multi-institutional retrospective study of patients with UC treated with tacrolimus or infliximab between January 2010 and March 2019. The proportion of clinical remission at week 8 and cumulative colectomy-free rate were examined using propensity score matching analysis. The predictors for colectomy after tacrolimus induction were also investigated. Ninety patients in the tacrolimus group and 151 in the infliximab group were enrolled. The proportion of patients in clinical remission at week 8 was 65.2% in the matched tacrolimus group and 37.3% in the matched infliximab group (P = 0.0016), and the long-term colectomy-free rate was lower in the matched tacrolimus group than in the matched infliximab group (P = 0.0003). After clinical remission with tacrolimus, a serum albumin level of ≤ 3.5 g/dL at week 8 was extracted as a factor predicting colectomy (area under the curve: 0.94). Tacrolimus showed a higher remission induction effect for UC compared to infliximab. However, a high rate of colectomy after transition to maintenance treatment was found to be a concern for tacrolimus therapy. |
| format | Article |
| id | doaj-art-9aa66e703de94afb9a080fcca243c426 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Nature Portfolio |
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| spelling | doaj-art-9aa66e703de94afb9a080fcca243c4262025-01-05T12:17:03ZengNature PortfolioScientific Reports2045-23222025-01-0115111210.1038/s41598-024-77365-yEffectiveness of tacrolimus therapy in refractory ulcerative colitis compared to infliximab with propensity score matchingTakeo Yoshihara0Takahiro Amano1Shinichiro Shinzaki2Yuri Tsujii3Akiko Asakura4Taku Tashiro5Mizuki Tani6Yuriko Otake-Kasamoto7Takuya Yamada8Yuko Sakakibara9Naoto Osugi10Shuji Ishii11Satoshi Egawa12Manabu Araki13Yuki Arimoto14Masanori Nakahara15Yoko Murayama16Ichizo Kobayashi17Kazuo Kinoshita18Hiroyuki Ogawa19Satoshi Hiyama20Narihiro Shibukawa21Masato Komori22Yorihide Okuda23Takashi Kizu24Tetsuhisa Kitamura25Minoru Kato26Yoshiki Tsujii27Takahiro Inoue28Hideki Iijima29Yoshito Hayashi30Tetsuo Takehara31Department of Gastroenterology and Hepatology, Osaka University Graduate School of MedicineDepartment of Gastroenterology and Hepatology, Osaka University Graduate School of MedicineDepartment of Gastroenterology and Hepatology, Osaka University Graduate School of MedicineDepartment of Gastroenterology and Hepatology, Osaka University Graduate School of MedicineDepartment of Gastroenterology and Hepatology, Osaka University Graduate School of MedicineDepartment of Gastroenterology and Hepatology, Osaka University Graduate School of MedicineDepartment of Gastroenterology and Hepatology, Osaka University Graduate School of MedicineDepartment of Gastroenterology and Hepatology, Osaka University Graduate School of MedicineDepartment of Gastroenterology and Hepatology, Osaka Rosai HospitalDepartment of Gastroenterology, National Hospital Organization Osaka National HospitalDepartment of Gastroenterology, Toyonaka Municipal HospitalDepartment of Gastroenterology, Osaka General Medical CenterDepartment of Gastroenterology, Osaka Police HospitalDepartment of Gastroenterology, National Hospital Organization Osaka Minami Medical CenterDepartment of Gastroenterology, Kansai Rosai HospitalDepartment of Gastroenterology, Ikeda City HospitalDepartment of Gastroenterology and Hepatology, Itami City HospitalDepartment of Gastroenterology, Higashiosaka City Medical CenterDepartment of Gastroenterology, Otemae HospitalDepartment of Gastroenterology, Nishinomiya Municipal Central HospitalDepartment of Gastroenterology, Japan Community Healthcare Organization Osaka HospitalDepartment of Gastroenterology, Daini Osaka Police HospitalDepartment of Gastroenterology, Hyogo Prefectural Nishinomiya HospitalDepartment of Gastroenterology, Saiseikai Senri HospitalDepartment of Gastroenterology, Yao Municipal HospitalEnvironmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka UniversityDepartment of Gastroenterology and Hepatology, Osaka University Graduate School of MedicineDepartment of Gastroenterology and Hepatology, Osaka University Graduate School of MedicineDepartment of Gastroenterology and Hepatology, Osaka University Graduate School of MedicineDepartment of Gastroenterology, Osaka Police HospitalDepartment of Gastroenterology and Hepatology, Osaka University Graduate School of MedicineDepartment of Gastroenterology and Hepatology, Osaka University Graduate School of MedicineAbstract There is insufficient evidence comparing the outcomes of tacrolimus-based remission induction therapy with infliximab in refractory ulcerative colitis (UC) and evidence regarding optimal strategies after tacrolimus-based remission induction therapy. We conducted a multi-institutional retrospective study of patients with UC treated with tacrolimus or infliximab between January 2010 and March 2019. The proportion of clinical remission at week 8 and cumulative colectomy-free rate were examined using propensity score matching analysis. The predictors for colectomy after tacrolimus induction were also investigated. Ninety patients in the tacrolimus group and 151 in the infliximab group were enrolled. The proportion of patients in clinical remission at week 8 was 65.2% in the matched tacrolimus group and 37.3% in the matched infliximab group (P = 0.0016), and the long-term colectomy-free rate was lower in the matched tacrolimus group than in the matched infliximab group (P = 0.0003). After clinical remission with tacrolimus, a serum albumin level of ≤ 3.5 g/dL at week 8 was extracted as a factor predicting colectomy (area under the curve: 0.94). Tacrolimus showed a higher remission induction effect for UC compared to infliximab. However, a high rate of colectomy after transition to maintenance treatment was found to be a concern for tacrolimus therapy.https://doi.org/10.1038/s41598-024-77365-yPropensity score matching analysisCalcineurin inhibitorsUlcerative colitis |
| spellingShingle | Takeo Yoshihara Takahiro Amano Shinichiro Shinzaki Yuri Tsujii Akiko Asakura Taku Tashiro Mizuki Tani Yuriko Otake-Kasamoto Takuya Yamada Yuko Sakakibara Naoto Osugi Shuji Ishii Satoshi Egawa Manabu Araki Yuki Arimoto Masanori Nakahara Yoko Murayama Ichizo Kobayashi Kazuo Kinoshita Hiroyuki Ogawa Satoshi Hiyama Narihiro Shibukawa Masato Komori Yorihide Okuda Takashi Kizu Tetsuhisa Kitamura Minoru Kato Yoshiki Tsujii Takahiro Inoue Hideki Iijima Yoshito Hayashi Tetsuo Takehara Effectiveness of tacrolimus therapy in refractory ulcerative colitis compared to infliximab with propensity score matching Scientific Reports Propensity score matching analysis Calcineurin inhibitors Ulcerative colitis |
| title | Effectiveness of tacrolimus therapy in refractory ulcerative colitis compared to infliximab with propensity score matching |
| title_full | Effectiveness of tacrolimus therapy in refractory ulcerative colitis compared to infliximab with propensity score matching |
| title_fullStr | Effectiveness of tacrolimus therapy in refractory ulcerative colitis compared to infliximab with propensity score matching |
| title_full_unstemmed | Effectiveness of tacrolimus therapy in refractory ulcerative colitis compared to infliximab with propensity score matching |
| title_short | Effectiveness of tacrolimus therapy in refractory ulcerative colitis compared to infliximab with propensity score matching |
| title_sort | effectiveness of tacrolimus therapy in refractory ulcerative colitis compared to infliximab with propensity score matching |
| topic | Propensity score matching analysis Calcineurin inhibitors Ulcerative colitis |
| url | https://doi.org/10.1038/s41598-024-77365-y |
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