title: Cyclosporin for severe ulcerative colitis attacks.
abstract: OBJECTIVE
  Cyclosporin-A is used as alternative medical therapy in steroid refractory ulcerative colitis with severe activity. In spite of known effectivity, the long term results of cyclosporin-A therapy is not clear for today.
  
  
  METHODS
  The results of 13 steroid refractory patients that treated with cyclosporin-A were retrospectively assessed. Cyclosporin-A was started as orally, 8 mg/kg/day in 4 patients and intravenously, 4 mg/kg/day in 9 patients. Intravenous therapy changed to oral therapy one week after beginning. Patients also received 5-ASA and azathioprine. Steroid was tapered.
  
  
  RESULTS
  Ten patients responded to treatment in a mean of 9 days (range: 2-30 days). Three unresponded patients underwent total colectomy on 7, 11 and 19th day of therapy. Ten initially responded patients received the drug for average 4.9 months. Of these, four relapsed during and one relapsed soon after therapy. Four of 5 relapser patients underwent colectomy. One patient that not accepted surgical intervention is still receiving medical therapy. Remaining 5 patients, 38% of total group; 50% of patients that initially responded, maintain the remission at the end of average 17 months of follow up period.
  
  
  CONCLUSIONS
  Cyclosporin-A therapy in severe ulcerative colitis that is refractory to steroids, provides initial remission in 80% of patients and allows 40% to retain their colon for 1 year.
authors.affiliation: Istanbul University, Istanbul School of Medicine, Gastroenterohepatology Department, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Danalioglu
authors.forename: Sabahattin
authors.initials: S
authors.lastname: Kaymakoglu
authors.forename: Zeynel
authors.initials: Z
authors.lastname: Mungan
authors.forename: Cetin
authors.initials: C
authors.lastname: Karaca
authors.forename: Kadir
authors.initials: K
authors.lastname: Demir
authors.forename: Ziyaettin
authors.initials: Z
authors.lastname: Durakoglu
authors.forename: Fatih
authors.initials: F
authors.lastname: Besisik
authors.forename: Gungor
authors.initials: G
authors.lastname: Boztas
authors.forename: Yilmaz
authors.initials: Y
authors.lastname: Cakaloglu
authors.forename: Atilla
authors.initials: A
authors.lastname: Okyen
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D003082:Colectomy; D003093:Colitis, Ulcerative / Q000150:complications / Q000628:therapy*; D016572:Cyclosporine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine