title: High-dose intravenous cyclosporine in steroid refractory attacks of inflammatory bowel disease.
abstract: OBJECTIVE
  To determin whether cyclosporine is effective in inducing remission in patients with severe active inflammatory bowel disease, refractory to steroids.
  
  
  METHODS
  Twenty-three patients with severe and steroid-refractory inflammatory bowel disease (15 ulcerative colitis and 8 Crohn's disease) were included. The Mayo Clinic Score and the CDAI were used to evaluate activity. Cyclosporine (4 mg/kg/day) was administered for a maximum of ten and a minimum of 7 days.
  
  
  RESULTS
  Ten of the 15 ulcerative colitis patients achieved remission with a mean response lag time to onset improvement of 8 days. Seven of these patients remained stable with mesalazine 4 months after cyclosporine treatment. Two patients relapsed and underwent colectomy on the 50th and 200th day after treatment. Five patients presented no response and required urgent colectomy. Six of the 8 Crohn's disease patients achieved remission with a mean response lag time to onset improvement of 7 days. The 6 patients remained stable with mesalazine four months after cyclosporine treatment. The other 2 developed reversible renal failure and had to be released from the study.
  
  
  CONCLUSIONS
  Intravenous high dose cyclosporine is effective and can be used as a rapid onset treatment for acute steroid refractory IBD.
authors.affiliation: Servicio de Aparato Digestivo, Hospital Universitario de la Princesa, Universidad Autonoma de Madrid, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Hermida-Rodriguez
authors.forename: J
authors.initials: J
authors.lastname: Cantero Perona
authors.forename: R
authors.initials: R
authors.lastname: Garcia-Valriberas
authors.forename: J M
authors.initials: JM
authors.lastname: Pajares Garcia
authors.forename: J
authors.initials: J
authors.lastname: Mate-Jimenez
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003093:Colitis, Ulcerative / Q000188:drug therapy* / Q000601:surgery; D003424:Crohn Disease / Q000188:drug therapy* / Q000601:surgery; D016572:Cyclosporine / Q000008:administration & dosage* / Q000009:adverse effects; D004351:Drug Resistance; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D007275:Injections, Intravenous; D008297:Male; D019804:Mesalamine / Q000627:therapeutic use; D008875:Middle Aged; D011446:Prospective Studies; D012074:Remission Induction
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D019804:Mesalamine; D016572:Cyclosporine