title: Long-term increase in serum cholesterol levels in ulcerative colitis patients treated with cyclosporine: an underdiagnosed side effect frequently associated with other drug-related complications.
abstract: BACKGROUND
  Several serious side effects may limit the use of cyclosporine. Cyclosporine has been reported to increase the total cholesterol level; however, the change in serum cholesterol levels before and after cyclosporine therapy has not been examined in ulcerative colitis (UC) patients. The purpose of this article was to compare serum cholesterol levels before and after cyclosporine therapy in patients with refractory UC and to examine the relationship between serum cholesterol levels and other common side effects.
  
  
  METHODS
  We prospectively assessed serum cholesterol levels in UC patients who had been treated with cyclosporine. Data of 72 patients were analyzed and compared to a control group treated with Infliximab.
  
  
  RESULTS
  The average duration of cyclosporine therapy was 9.6 months, and side effects developed in 52 patients. Elevated cholesterol levels were detected in 47.2% of the patients. Serum cholesterol levels were significantly increased during and after discontinuation of cyclosporine therapy compared to the time before use of the drug. However, cholesterol levels measured during cyclosporine therapy were significantly higher compared to the time after its discontinuation (p < 0.001). Patients with drug-related side effects showed higher cholesterol levels after discontinuation of the therapy compared to those who did not experience any adverse events.
  
  
  CONCLUSIONS
  Our findings suggest that cyclosporine therapy may result in increased serum cholesterol levels even in the long-term, after discontinuation of the therapy. Considering that significantly higher post-therapy cholesterol levels were more common in patients who developed drug-related complications, routine measurement of serum cholesterol may increase the safety of the drug.
authors.affiliation: Department I of Medicine, University of Szeged , Szeged , Hungary.
authors.forename: Anita
authors.initials: A
authors.lastname: Bálint
authors.forename: Klaudia
authors.initials: K
authors.lastname: Farkas
authors.forename: Mónika
authors.initials: M
authors.lastname: Szűcs
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Szepes
authors.forename: Ferenc
authors.initials: F
authors.lastname: Nagy
authors.forename: Tibor
authors.initials: T
authors.lastname: Wittmann
authors.forename: Tamás
authors.initials: T
authors.lastname: Molnár
mesh_terms: D000293:Adolescent; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D002784:Cholesterol / Q000097:blood*; D003093:Colitis, Ulcerative / Q000097:blood* / Q000188:drug therapy*; D003404:Creatinine / Q000097:blood; D016572:Cyclosporine / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000139:chemically induced*; D006973:Hypertension / Q000139:chemically induced; D006983:Hypertrichosis / Q000139:chemically induced; D015228:Hypertriglyceridemia / Q000097:blood / Q000139:chemically induced; D006987:Hypesthesia / Q000139:chemically induced; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D063806:Myalgia / Q000139:chemically induced; D011446:Prospective Studies; D013997:Time Factors; D014202:Tremor / Q000139:chemically induced; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D002784:Cholesterol; D003404:Creatinine; D000069285:Infliximab