title: Oral microemulsion cyclosporine in the treatment of steroid-refractory attacks of ulcerative and indeterminate colitis.
abstract: BACKGROUND
  To assess the efficacy of oral microemulsion cyclosporine (CyA Neoral) in the treatment of steroid-refractory attacks of ulcerative an indeterminate colitis.
  
  
  METHODS
  In this non-randomized study on the use of oral microemulsion cyclosporine in steroid refractory ulcerative colitis, we used CyA Neoral in 10 patients suffering from ulcerative colitis and in 1 patient suffering from indeterminate colitis with a steroid-refractory attack. The initial dose was 7-7.5 mg kg-1 day-1 adjusted to maintain whole blood cyclosporine levels between 250 and 350 ng/mL, as measured by RIA using monoclonal antibodies.
  
  
  RESULTS
  Nine patients presented a favourable response in a mean time of 3.6 days, that is, 81.8% of cases. One initial responder developed megacolon on the 11th day and another did not respond; surgical treatment was performed in both cases. The remaining nine patients, followed for a mean period of 14.6 months (2-36 months). Nine patients presented side effects, the most frequent being slight hand tremor with hypomagnesaemia, followed by hypertension, slight increase in creatinine and hirsutism. No one needed to withdraw from treatment, but the dose was lowered in three cases.
  
  
  CONCLUSIONS
  Oral microemulsion cyclosporine is an effective drug in the initial management of patients suffering from a steroid-refractory attack of ulcerative and indeterminate colitis. Additional controlled studies with the new oral formulation are required to confirm these results.
authors: Sección de Aparato Digestivo, Servicio de Digestivo (Unidad de endoscopia), Hospital Nuestra Sra. de Candelaria, Carretera del Rosario s/n, 38010 Santa Cruz de Tenerife, España. gastrocand@hcan.rcanaria.es
authors: L
authors: L
authors: Navazo
authors: H
authors: H
authors: Salata
authors: S
authors: S
authors: Morales
authors: M C
authors: MC
authors: Dorta
authors: F
authors: F
authors: Pérez
authors: D
authors: D
authors: de las Casas
authors: J
authors: J
authors: Avilés
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D003092:Colitis / Q000188:drug therapy*; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D016572:Cyclosporine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004655:Emulsions; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D013997:Time Factors
chemical_list: D004655:Emulsions; D007166:Immunosuppressive Agents; D016572:Cyclosporine