Cyclosporin for severe ulcerative colitis attacks.
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.
Danalioglu
Ahmet
A
Istanbul University, Istanbul School of Medicine, Gastroenterohepatology Department, Turkey.
Kaymakoglu
Sabahattin
S
Mungan
Zeynel
Z
Karaca
Cetin
C
Demir
Kadir
K
Durakoglu
Ziyaettin
Z
Besisik
Fatih
F
Boztas
Gungor
G
Cakaloglu
Yilmaz
Y
Okyen
Atilla
A
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
D007166:Immunosuppressive Agents; D016572:Cyclosporine