title: Endoscopic and histologic response to cyclosporine in ulcerative colitis and their impact on disease outcome: A cohort study.
abstract: BACKGROUND
  Cyclosporine (CsA) is an effective agent for treating patients with acute steroid-refractory ulcerative colitis (UC). The aim was to assess endoscopic and histologic responses to CsA and to determine their predictive value on UC outcome.
  
  
  METHODS
  Consecutive UC patients who received intravenous CsA for an acute refractory UC were included when they had endoscopic assessments with biopsies at entry and, at CsA interruption in responders. Mucosal healing (MH) was defined by Mayo endoscopic subscore ≤1 and, histologic response (HR) by the absence of basal plasmocytosis or a Geboes score <3.1.
  
  
  RESULTS
  Among 21 patients who responded to CsA, MH was achieved in 81%. Survival rates without relapse at 2 years were 79% and 25% in patients with MH and without MH, respectively (p=0.04). HR was observed in 84% of patients according to basal plasmocytosis and in 68% according to Geboes score. Multivariate analysis revealed that a Mayo endoscopic subscore of 0 was the only prognostic factor associated with absence of relapse (RR=12; 95%CI: 1.05-136.79).
  
  
  CONCLUSIONS
  CsA provides MH and HR in most of UC patients responding to this drug. As suggested with other UC treatments, a complete MH with CsA has a good prognostic value.
authors.affiliation: CHU de Bordeaux, Gastroenterology Department, Hôpital Haut-Lévêque, Université de Bordeaux, INSERM CIC 1401, Bordeaux, France.
authors.forename: Clémence
authors.initials: C
authors.lastname: Fron
authors.affiliation: CHU de Bordeaux, Pathology Department, Hôpital Haut-Lévêque, Bordeaux, France.
authors.forename: Clémence
authors.initials: C
authors.lastname: Pierry
authors.affiliation: CHU de Bordeaux, Gastroenterology Department, Hôpital Haut-Lévêque, Université de Bordeaux, INSERM CIC 1401, Bordeaux, France.
authors.forename: Florian
authors.initials: F
authors.lastname: Poullenot
authors.affiliation: CHU de Bordeaux, Gastroenterology Department, Hôpital Haut-Lévêque, Université de Bordeaux, INSERM CIC 1401, Bordeaux, France.
authors.forename: Edouard
authors.initials: E
authors.lastname: Chabrun
authors.affiliation: CHU de Bordeaux, Gastroenterology Department, Hôpital Haut-Lévêque, Université de Bordeaux, INSERM CIC 1401, Bordeaux, France.
authors.forename: Clément
authors.initials: C
authors.lastname: Subtil
authors.affiliation: CHU de Bordeaux, Gastroenterology Department, Hôpital Haut-Lévêque, Université de Bordeaux, INSERM CIC 1401, Bordeaux, France.
authors.forename: Maylis
authors.initials: M
authors.lastname: Capdepont
authors.affiliation: CHU de Bordeaux, Gastroenterology Department, Hôpital Haut-Lévêque, Université de Bordeaux, INSERM CIC 1401, Bordeaux, France.
authors.forename: Frank
authors.initials: F
authors.lastname: Zerbib
authors.affiliation: CHU de Bordeaux, Pathology Department, Hôpital Haut-Lévêque, Bordeaux, France.
authors.forename: Geneviève
authors.initials: G
authors.lastname: Belleannée
authors.affiliation: CHU de Bordeaux, Gastroenterology Department, Hôpital Haut-Lévêque, Université de Bordeaux, INSERM CIC 1401, Bordeaux, France. Electronic address: david.laharie@chu-bordeaux.fr.
authors.forename: David
authors.initials: D
authors.lastname: Laharie
mesh_terms: D000208:Acute Disease; D061605:Administration, Intravenous; D000293:Adolescent; D000328:Adult; D000368:Aged; D003093:Colitis, Ulcerative / Q000188:drug therapy* / Q000473:pathology; D003113:Colonoscopy; D016572:Cyclosporine / Q000627:therapeutic use*; D005260:Female; D005602:France; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007413:Intestinal Mucosa / Q000187:drug effects / Q000473:pathology*; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012008:Recurrence; D012074:Remission Induction; D012189:Retrospective Studies; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine
keywords: Cyclosporine; Histologic remission; Mucosal healing; Ulcerative colitis