Efficacy of cyclosporin in severe ulcerative colitis attack.
OBJECTIVE
Cyclosporin-A is used as a alternative medical therapy in steroid resistant ulcerative colitis with severe activity. In spite of its known efficacy, the long term effects of are not entirely clear.


METHODS
The records of 13 steroid resistant patients treated with cyclosporin-A were retrospectively assessed. Cyclosporin-A had been prescribed orally at a dose of 8 mg/kg/day in four patients and intravenously, 4mg/kg/day in nine patients. Intravenous therapy was changed to oral therapy after one week and patients also received 5-ASA and azathioprine. Steroid treatment was tapered.


RESULTS
Ten patients responded to treatment in a mean of nine days (range: 2-30 days). Three patients who did not respond underwent total colectomy on day seven, 11 and 19 of therapy. The 10 patients who initially responded received the drug for an average of 4.9 months; four of these relapsed during and one relapsed soon after discontinuation of therapy. Four of the five patients who relapsed underwent colectomy and the one patient who did not accept surgical intervention continued medical therapy. The remaining five patients (38% of the total group; 50% of the patients who initially responded) remained in remission at the end of an average 17 month follow up period.


CONCLUSIONS
Cyclosporin-A therapy in severe ulcerative colitis that is resistant to steroids, provides initial remission in 80% of patients and allows 40% to retain their colon for one year.
Danalioğlu
Ahmet
A
Istanbul Medical School, Department of Gastroenterology and Hepatology. drahmetdan@yahoo.com
Kaymakoğlu
Sabahattin
S
Mungan
Zeynel
Z
Karaca
Cetin
C
Demir
Kadir
K
Durakoğlu
Ziyaettin
Z
Beşişik
Fatih
F
Boztaş
Güngör
G
Cakaloğlu
Yilmaz
Y
Okten
Atilla
A