Review: optimizing rescue therapy in acute severe ulcerative colitis using infliximab pharmacokinetics-a practical guide for clinicians

Background

Corticosteroid-refractory acute severe ulcerative colitis (ASUC) remains a key management challenge despite an increasing understanding of rescue strategies. Due to the relative paucity of high-quality evidence, the use of infliximab in ASUC should be informed by pragmatic application of key clinical and pharmacological principles. This review synthesizes emerging evidence of infliximab pharmacology, describes key concepts of mechanisms of infliximab failure, and suggests an optimized approach to using infliximab in ASUC.