title: Low-dose cyclosporin for Crohn's disease: implications for clinical trials.
abstract: 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 Three patients were withdrawn despite clinical improvement.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.
authors.affiliation: Department of Internal Medicine, Herlev University Hospital, Denmark.
authors.forename: J
authors.initials: J
authors.lastname: Brynskov
authors.forename: V
authors.initials: V
authors.lastname: Binder
authors.forename: P
authors.initials: P
authors.lastname: Riis
authors.forename: K
authors.initials: K
authors.lastname: Lauritsen
authors.forename: O
authors.initials: O
authors.lastname: Schaffalitzky de Muckadell
authors.forename: L
authors.initials: L
authors.lastname: Freund
authors.forename: J
authors.initials: J
authors.lastname: Fallingborg
authors.forename: S
authors.initials: S
authors.lastname: Nørby Rasmussen
authors.forename: P
authors.initials: P
authors.lastname: Matzen
authors.forename: E
authors.initials: E
authors.lastname: Krag
mesh_terms: 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
chemical_list: D003524:Cyclosporins