Infliximab effect for ulcerative colitis
Clinical Question
Is infliximab effective in decreasing symptoms in patients with ulcerative colitis?
Bottom Line
Infliximab is effective in patients with moderate to severe ulcerative colitis, as well as in patients with Crohn's disease. Approximately half the patients will achieve long-term symptom reduction, and approximately 40% will achieve long-term remission. (LOE = 1a-)
Reference
Gisbert JP, Gonzalez-Lama Y, Mate J. Systematic review: infliximab therapy in ulcerative colitis. Aliment Pharmacol Ther 2006;25:19-37. [PMID:17229218]
Study Design
Meta-analysis (randomized controlled trials)
Funding
Government
Setting
Various (meta-analysis)
Synopsis
Infliximab is a monoclonal antibody directed against tumor necrosis factor-alpha and is used in the treatment of active Crohn's disease. The Spanish researchers performing this meta-analysis identified 34 studies enrolling a total of 896 patients with ulcerative colitis. Methods for determining study inclusion and for data abstraction were not described. The authors found the articles by searching 5 databases for randomized trials comparing infliximab with either placebo or steroids. Approximately 64% of patients in the included studies had severe disease, 52% were steroid-resistant, and approximately 46% were also receiving immunosuppressant therapy. All the studies were of high quality. Two weeks following treatment, 68% of patients, on average, responded (95% CI, 65-71%) and 40% achieved remission (36% - 44%). At 9 months, approximately 50% responded and remission occurred in 39% (number needed to treat = 3 - 5). Adverse effects reports are frequent with both infliximab and placebo, though greater with infliximab (number needed to treat to harm = 14).
Citation
Barry, Henry, et al., editors. "Infliximab Effect for Ulcerative Colitis." EE+ POEM Archive, John Wiley & Sons, 2025. Evidence Central, evidence.unboundmedicine.com/evidence/view/infoPOEMs/426386/1/Infliximab_effect_for_ulcerative_colitis.
Infliximab effect for ulcerative colitis. In: Barry HH, Ebell MHM, Shaughnessy AFA, et al, eds. EE+ POEM Archive. John Wiley & Sons; 2025. https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426386/1/Infliximab_effect_for_ulcerative_colitis. Accessed August 2, 2025.
Infliximab effect for ulcerative colitis. (2025). In Barry, H., Ebell, M. H., Shaughnessy, A. F., & Slawson, D. C. (Eds.), EE+ POEM Archive. John Wiley & Sons. https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426386/1/Infliximab_effect_for_ulcerative_colitis
Infliximab Effect for Ulcerative Colitis [Internet]. In: Barry HH, Ebell MHM, Shaughnessy AFA, Slawson DCD, editors. EE+ POEM Archive. John Wiley & Sons; 2025. [cited 2025 August 02]. Available from: https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426386/1/Infliximab_effect_for_ulcerative_colitis.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Infliximab effect for ulcerative colitis
ID - 426386
ED - Barry,Henry,
ED - Ebell,Mark H,
ED - Shaughnessy,Allen F,
ED - Slawson,David C,
BT - EE+ POEM Archive
UR - https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426386/1/Infliximab_effect_for_ulcerative_colitis
PB - John Wiley & Sons
DB - Evidence Central
DP - Unbound Medicine
ER -