title: [Chronic active ulcerative colitis. Efficacy of intravenous followed by oral cyclosporine combined with azathioprine].
abstract: 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.
authors.affiliation: Unité Inserm 407, Faculté de médecine Lyon Sud, Oullins. driffamme@aol.com
authors.forename: Driffa
authors.initials: D
authors.lastname: Moussata
authors.forename: Stéphane
authors.initials: S
authors.lastname: Nancey
authors.forename: Bernard
authors.initials: B
authors.lastname: Flourié
authors.forename: Sylvette Claudel
authors.initials: SC
authors.lastname: Bonvoisin
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Cenni
authors.forename: Louis
authors.initials: L
authors.lastname: Descos
mesh_terms: 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
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D001379:Azathioprine