Low-dose cyclosporin for Crohn's disease: implications for clinical trials.
Cyclosporin is a potent immunosuppressant, which has gained recent interest as a possible treatment for Crohn's disease. Chronic nephrotoxicity, however, has recently been demonstrated as a result of early treatment with high initial cyclosporin doses. We report the effect of a 3-month treatment with low-dose cyclosporin (5-7.5 mg kg-1 day-1) in 11 chronically active, therapy-resistant Crohn's disease patients. Eight of the 11 patients (72%) improved according to a clinical grading score and the Dutch Activity Index whereas 9/11 (82%) improved according to the Crohn's Disease Activity Index (P less than 0.05) after 1 month. Three patients were withdrawn despite clinical improvement. One developed arterial hypertension, one dropped out and one required surgical treatment due to a small bowel stricture. Five patients (45%) completed the treatment period with improved clinical scores. After tapering-off, two patients (18%) were better at follow-up. No serious side-effects were encountered and it is concluded that low-dose cyclosporin treatment should be further investigated in Crohn's disease.
Brynskov
J
J
Department of Internal Medicine, Herlev University Hospital, Denmark.
Binder
V
V
Riis
P
P
Lauritsen
K
K
Schaffalitzky de Muckadell
O
O
Freund
L
L
Fallingborg
J
J
Nørby Rasmussen
S
S
Matzen
P
P
Krag
E
E
D000328:Adult; D003424:Crohn Disease / Q000188:drug therapy* / Q000473:pathology; D003524:Cyclosporins / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D016032:Randomized Controlled Trials as Topic
D003524:Cyclosporins