Introduction Prescription of a-TNF therapy in UC in the UK is limited to acute severe colitis by NICE. Increasingly physicians are under pressure from patients to offer an alternative to the traditional limited therapeutic options and this has resulted in the drug being used in the subacute setting, as it is in other countries.
Methods A retrospective review of all patients receiving a-TNF for UC up until December 2012.
Results Twenty-one patients have received a-TNF therapy for UC. Five are currently on a-TNF treatment, 4 of whom commenced in the last 12 months. Twelve were discontinued for non-response, 1 for funding, 1 for remission, 2 for side effects and 1 at the patient’s request. Two were switched. Response to the agents are shown in Table 1.
Thirteen received infliximab as first agent, eight had adalimumab. Seven were on other immunomodulators at the time of commencing a-TNF and 11 were intolerant to immunomodulators. Three had a-TNF for acute colitis, 15 for subacute colitis and data unknown for 3 patients.
Currently 3 patients are in clinical remission, 11 had surgery and 7 have active disease (with 2 strongly recommended to have surgery). Twelve patients had steroids while on a-TNF. Mean time on a-TNF was 4.7 months.
Conclusion a-TNF use in UC does not appear to be very effective in this context, with 62% having or requiring surgery and 60% requiring concurrent steroids. To make this therapy more cost effective in this patient group more work is needed to identify patients likely to be responders.
Disclosure of Interest None Declared.
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