Infliximab vs. Cyclosporine for Steroid-Refractory Ulcerative Colitis

Patients with acute severe ulcerative colitis are typically hospitalized and treated with intravenous steroids, and nonresponders are typically treated with surgery, infliximab, or cyclosporine. To determine whether infliximab or cyclosporine is superior in this setting, investigators conducted a systematic review and meta-analysis of 16 studies involving 1473 patients with acute severe steroid-refractory ulcerative colitis.

In three randomized, controlled trials, treatment response was similar with infliximab and cyclosporine, as were colectomy rates at 3 and 12 months. In 13 nonrandomized studies, infliximab was associated with higher response rates (odds ratio, 2.96) and a lower colectomy rate at 12 months (OR, 0.42), but similar rates of…