Tag Archives: Monoclonal Antibodies

Infliximab for Induction and MaintenanceTherapy for Ulcerative Colitis

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Ulcerative colitis is characterized by mucosal ulceration, rectal bleeding, diarrhea, and abdominal pain. Pharmacologic management of ulcerative colitis has relied mainly on 5-aminosalicylates, corticosteroids, and immunosuppressants, including purine antimetabolites and cyclosporine. Corticosteroid dependence is a clinically important problem; furthermore, the probability of colectomy within the first five years after diagnosis ranges from 9 percent in patients with distal colitis to 35 percent in patients with total colitis, most commonly because of failed medical therapy. The cumulative risk of recurrent inflammatory bowel disease in the form of pouchitis ranges from 15.5 percent one year after the procedure to 45.5 percent 10 years after the procedure. Accordingly, new treatments for ulcerative colitis are needed.”

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Bevacizumab and Surgical Wound Healing

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“Bevacizumab has been associated with multiple complications in regard to wound healing, such as dehiscence, ecchymosis, surgical site bleeding, and wound infection. Current literature suggests patients should wait at least 6 to 8 weeks (40 days) after cessation to have surgery (half-life 20 days). In addition, postoperative reinitiation of bevacizumab must wait 28 days to prevent an increased risk of wound healing complications, and the surgical incision should be fully healed”

(Gordon)
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Article of Interest: Combined Nivolumab and Ipilimumab or Monotherapy in Untreated Melanoma

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Larkin J, Chiarion-Sileni V, Gonzalez R, et al. Combined Nivolumab and Ipilimumab or Monotherapy in Untreated Melanoma. N Engl J Med. 2015 Jul 2;373(1):23-34. Erratum in: N Engl J Med. 2018 Nov 29;379(22):2185. Free full-text.

Results: The median progression-free survival was 11.5 months (95% confidence interval [CI], 8.9 to 16.7) with nivolumab plus ipilimumab, as compared with 2.9 months (95% CI, 2.8 to 3.4) with ipilimumab (hazard ratio for death or disease progression, 0.42; 99.5% CI, 0.31 to 0.57; P<0.001), and 6.9 months (95% CI, 4.3 to 9.5) with nivolumab (hazard ratio for the comparison with ipilimumab, 0.57; 99.5% CI, 0.43 to 0.76; P<0.001). In patients with tumors positive for the PD-1 ligand (PD-L1), the median progression-free survival was 14.0 months in the nivolumab-plus-ipilimumab group and in the nivolumab group, but in patients with PD-L1-negative tumors, progression-free survival was longer with the combination therapy than with nivolumab alone (11.2 months [95% CI, 8.0 to not reached] vs. 5.3 months [95% CI, 2.8 to 7.1]). Treatment-related adverse events of grade 3 or 4 occurred in 16.3% of the patients in the nivolumab group, 55.0% of those in the nivolumab-plus-ipilimumab group, and 27.3% of those in the ipilimumab group.

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