ÖZET • Giriş ve Amaç: Ülseratif kolitli Hastaların üçte biri akut şiddetli ülseratif kolit ile basvurmakta ve kortikosteroid tedavisi gerekmektedir. çalışmada kortikosteroide yanitsiz hastalarda infliksimab ve biyobenzerlerinin kurtarma tedavisinde kolektomisiz sag kalim üzerine etkisi arastirilmıştır. Gereç ve Yöntem: Truelove-Witts aktivite indeksine göre şiddetli kolit kriterlerini karsilayan ve intravenöz kortikosteroid tedavisine yanitsiz olmasi nedeniyle infliksimab kurtarma tedavisi verilen 48 hasta retrospektif olarak değerlendirildi. Klinik kötülesme, yeni tedaviye geçilme gerekliliği ve kolektomi ihtiyaci progresyon olarak tanımlandi. Kisa süreli (3 ay) ve uzun süreli (12 ay) kolektomisiz sag kalim primer sonlanim olarak kabul edildi. Ayrıca orijinal ve biyobenzer infliksimab etkinlik açısından karsilastirildi. Bulgular: 14 hastaya orijinal infliksimab, 34 hastaya biyobenzer infliksimab tedavisi verilmisti. Kisa ve uzun süreli sonlanimda hiçbir hastada kolektomi ihtiyaci saptanmadi. Iki yıl ve üzerinde biyobenzer infliksimab tedavisi alan iki hastaya kolektomi uygulanmis olduğu saptandi. Progresyon varligina göre sag kalim sürelerinin istatistiksel olarak farklilik gösterdigi belirlendi (p < 0.001). Genel sag kalim süresinin ise farklilik göstermedigi saptandi (p > 0.05). Sonuç: Kortikosteroide refrakter şiddetli ülseratif kolitli hastalarda kolektomisiz sag kalim için hem orijinal hem de biyobenzer infliksimab etkili bulundu.
Background and Aims: One-third of patients with acute severe ulcerative colitis necessitate corticosteroid treatment. This study aimed to evaluate the efficacy of infliximab and its biosimilars on colectomy-free survival as a rescue therapy in corticosteroid-refractory patients. Materials and Methods: This retrospective study evaluated 48 patients meeting the criteria for severe colitis according to the Truelove-Witts activity index. The study group included patients refractory to intravenous corticosteroid therapy who received rescue treatment with infliximab. Progression was defined as clinical deterioration, the need for new treatment, and the need for colectomy. The primary outcomes were short-term (3 months) and long-term (12 months) colectomy-free survival. The efficacy of originator and biosimilar infliximab was also compared. Results: Fourteen patients were treated with originator Infliximab and 34 with biosimilar infliximab. Both short-term and long-term survival outcomes showed no immediate need for colectomy. Two patients in the biosimilar infliximab group underwent total colectomy operation more than two years after treatment. Survival times was statistically different according to the presence of progression (p < 0.001). However, there was no significant difference in overall survival between the groups (p > 0.05). Conclusions: Both originator and biosimilar infliximab are effective in achieving colectomy-free survival in patients with severe ulcerative colitis refractory to corticosteroids.