title: Cyclosporin for severe ulcerative colitis.
abstract: BACKGROUND
  About one-third of patients with severe ulcerative colitis do not respond to conventional therapy and require urgent colectomy. It was recently shown that cyclosporin is effective in some of these patients.
  
  
  OBJECTIVE
  To review the current experience of six hospitals in central Israel that used cyclosporin in patients with severe ulcerative colitis.
  
  
  METHODS
  The files of all 32 patients treated with cyclosporin for corticosteroid-resistant ulcerative colitis were reviewed. Activity of disease was measured by a clinical activity, index colonoscopy and laboratory tests.
  
  
  RESULTS
  The average duration of treatment with intravenous cyclosporin was 12.7 days (range 9-28) after which the disease activity index dropped from an average of 14.22 to 4.74. The mean time for response was 7.5 days (4-14). Twelve patients (40%) required surgery within 6 months and another 6 patients (18.8%) were operated on after more than 6 months. Twelve patients (37%) maintained remission for at least 6 months and did not require surgery. In one patient treatment was stopped because of non-compliance and one was lost to follow-up. There were numerous side effects, but in only one case with neurotoxicity was treatment withdrawn.
  
  
  CONCLUSIONS
  Cyclosporin is a relatively safe and effective treatment for severe ulcerative colitis. It induced long-term remission in 37% of the patients, and in those who required surgery the treatment resulted in an improved clinical condition before the operation.
authors.affiliation: Department of Gastroenterology, Meir Hospital, Kfar Saba. natali@post.tau.ac.il
authors.forename: T
authors.initials: T
authors.lastname: Naftali
authors.forename: B
authors.initials: B
authors.lastname: Novis
authors.forename: I
authors.initials: I
authors.lastname: Pomeranz
authors.forename: G
authors.initials: G
authors.lastname: Leichtman
authors.forename: Y
authors.initials: Y
authors.lastname: Maor
authors.forename: R
authors.initials: R
authors.lastname: Shapiro
authors.forename: M
authors.initials: M
authors.lastname: Moskowitz
authors.forename: B
authors.initials: B
authors.lastname: Avidan
authors.forename: Y
authors.initials: Y
authors.lastname: Avni
authors.forename: Y
authors.initials: Y
authors.lastname: Bujanover
authors.forename: Z
authors.initials: Z
authors.lastname: Fireman
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D016572:Cyclosporine / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine