title: The role of tacrolimus in inflammatory bowel disease: a systematic review.
abstract: Therapeutic management of inflammatory bowel disease remains beyond the limits of conventional therapy in many cases. Novel therapies used include tacrolimus, a new powerful immunosuppressive drug, employed in some case reports and a few studies that have tried to evaluate its effectiveness in Crohn's disease and ulcerative colitis with promising results, but its role in the management of inflammatory bowel disease remains controversial. We performed a systematic review that analyzed a total of 23 reported experiences in 286 patients with inflammatory bowel disease treated with tacrolimus. Although most of the published studies are uncontrolled, short, and heterogeneous, promising results have been obtained in fistulizing disease, unresponsive cases of both ulcerative colitis and Crohn's disease, and even extraintestinal manifestations. The overall outcome was good enough to consider tacrolimus as a rationale therapeutic option. However, comparative studies with standard therapeutic options like infliximab are needed to assess the correct role that tacrolimus may play in these patients.
authors.affiliation: Digestive Department, La Princesa University Hospital, Diego de Leon 62, Madrid 28006, Spain. ygonzalezlama@telefonica.net
authors.forename: Yago
authors.initials: Y
authors.lastname: Gonzalez-Lama
authors.forename: Javier P
authors.initials: JP
authors.lastname: Gisbert
authors.forename: Jose
authors.initials: J
authors.lastname: Mate
mesh_terms: D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D007412:Intestinal Fistula / Q000188:drug therapy / Q000209:etiology; D016559:Tacrolimus / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus