[Efficacy and safety of cyclosporine in the treatment of inflammatory bowel disease in children - a retrospective study].
OBJECTIVE
the aim of this study was to report single centre experience with cyclosporine used in treatment of children with inflammatory bowel disease with regard to safety and efficacy.


METHODS
retrospective analysis included 23 patients, 21 with ulcerative colitis and 2 with Crohn's disease, aged 2.75 to 18.5 years. They were treated with cyclosporine during the last 5 years. Before cyclosporine therapy was started they received steroids and azathioprine. Cyclosporine treatment was given in severe steroid-resistant exacerbation of the disease (n = 10) or steroid-dependence (n = 13). Cyclosporine dose was set to obtain therapeutic levels (serum concentration > 100 ng/ml and < 200 ng/ml).


RESULTS
Cyclosporine treatment was continued up to 2 months in 6 cases, 2 to 6 months in 8 patients and more than 6 months in 9 patients. Complications were reported in 2 patients: hirsutism and gingival hypertrophy. Cyclosporine treatment was stopped in the second case. None of the two patients with Crohn's disease improved during the treatment. Short-term improvement was observed in 11 patients with ulcerative colitis. Long-term recovery (> 6 months) was obtained in 6 cases. In 10 patients with severe exacerbation of ulcerative colitis colectomy was performed, in 4 of them elective surgery was performed when the clinical status improved.


CONCLUSIONS
cyclosporine appears to be a safe and relatively effective treatment of ulcerative colitis in children. Cyclosporine is less effective in maintaining remission and it did not allow to avoid colectomy in severe exacerbation. Still case controlled studies are needed to show the efficacy of this treatment.
Socha
Piotr
P
Klinika Gastroenterologii, Hepatologii i Immunologii, Instytut Pomnik Centrum Zdrowia Dziecka, Al. Dzieci Polskich 20, 03-740 Warszawa, Poland.
Wawer
Zofia
Z
Ryzko
Józef
J
Orłowska
Ewa
E
Szczepański
Michał
M
Kierkus
Jarosław
J
Celińska-Cedro
Danuta
D
Socha
Jerzy
J
D000284:Administration, Oral; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003093:Colitis, Ulcerative / Q000188:drug therapy; D003424:Crohn Disease / Q000188:drug therapy; D016572:Cyclosporine / Q000009:adverse effects / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy*; D012074:Remission Induction; D012189:Retrospective Studies; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D016572:Cyclosporine