[Chronic active ulcerative colitis. Efficacy of intravenous followed by oral cyclosporine combined with azathioprine].
OBJECTIVE
To know whether the therapeutic protocol applied in the case of severe acute ulcerative colitis (UC) associating ciclosporine and azathioprine was also effective in the case of moderate chronic active ulcerative colitis (UC).


METHODS
in this retrospective study 10 patients (31-65 years, 6 distal colitis, 1 left colitis, 3 pancolitis) moderately active and corticosteroid-resistant or dependent were included. Patients received ciclosporine intraveinously (4 mg/kg/d) and were evaluated 10 days later. If efficient, ciclosporine was given orally for 3 Months, azathioprine was introduced and steroids were progressively tapered.


RESULTS
on inclusion the clinical score, based on the Mayo Clinic score, was of 5.7 +/- 0.5. On Day 10, the score decreased significantly (2.1 +/- 0.7, p<0.001) and the therapeutic effect was sustained at the third Month (1.8 +/- 0.7). With azathioprine, 4 patients were still in remission with a mean follow up of 23.3 +/- 15.5 Months.


CONCLUSIONS
therapeutic scheme proposed in severe acute UC failing to respond to steroids may be helpful in some patients with a chronic active UC. Clinical improvement is rapid and long-term response is maintained in about 1 patient out of 2.
Moussata
Driffa
D
Unité Inserm 407, Faculté de médecine Lyon Sud, Oullins. driffamme@aol.com
Nancey
Stéphane
S
Flourié
Bernard
B
Bonvoisin
Sylvette Claudel
SC
Cenni
Jean-Claude
JC
Descos
Louis
L
D000208:Acute Disease; D000284:Administration, Oral; D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D001379:Azathioprine / Q000008:administration & dosage*; D002908:Chronic Disease; D003093:Colitis, Ulcerative / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D016572:Cyclosporine / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D016903:Drug Monitoring; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D012074:Remission Induction / Q000379:methods; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D001379:Azathioprine