Published online Jun 14, 2021. doi: 10.3748/wjg.v27.i22.3109
Peer-review started: March 5, 2021
First decision: March 27, 2021
Revised: April 11, 2021
Accepted: May 22, 2021
Article in press: May 22, 2021
Published online: June 14, 2021
There are cases of refractory ulcerative colitis in which tacrolimus does not induce remission.
A biomarker capable of predicting the induction effect of tacrolimus is desired.
The usefulness of serum albumin as a predictor of the therapeutic effect of oral tacrolimus for ulcerative colitis was investigated.
Patients treated with tacrolimus at our hospital were divided into a remission group and a failure group, and data including serum albumin at the start of observation and at the first and second weeks were retrospectively examined.
Lower albumin levels in week 2 than in week 0 after achieving trough levels of tacrolimus were shown to increase risk for failure, including colectomy and switch to biologics, within 3 mo.
Early serum albumin changes in patients with ulcerative colitis treated with tacrolimus predict clinical outcome.
In cases where albumin levels in week 2 are lower than week 0, changes to other treatment options, including surgical total colectomy, should be considered as soon as possible.