An Alternative to “Rescue Infliximab” for Refractory Ulcerative Colitis

Medical treatment strategies for refractory ulcerative colitis are limited. In particular, patients with a history of anti–tumor necrosis factor (TNF) exposure have few choices.

In a retrospective observational study by GETAID, a French collaborative group, patients with severe active ulcerative colitis received a calcineurin inhibitor as induction therapy, then vedolizumab as maintenance therapy. Thirty-six of the 39 had already failed anti-TNF therapy. Thirty-seven patients received cyclosporine intravenously or by mouth, and 2 received tacrolimus by mouth as initial therapy; vedolizumab was started after a median interval of 7 days following thereafter. The primary study endpoint was surgery-free survival.

Eleven patients underwent colecto…