BACKGROUND: Cyclosporine is a rescue treatment alternative to avoid colectomy in corticosteroid refractory acute severe ulcerative colitis. In this study, we aimed to evaluate the long-term efficacy and safety of cyclosporine therapy in acute severe ulcerative colitis patients. METHODS: Acute severe ulcerative colitis (basal Lichtiger score > 10) patients who did not respond to 40 mg intravenous methylpredniso- lone therapy after 3-5 days were included in the study. The presence of clinical response and remission was assessed at 1st week, 1st, 6th, and 12th month according to the Lichtiger index. RESULTS: In this study, 40 patients, whose steroid refractory acute severe ulcerative colitis and basal Lichtiger score > 10 points were enrolled. The median disease duration was 49.3 months (2-204). All patients received cyclosporine for 132 ± 78 days (7-270). Clinical response was obtained on seventh day in 82.5%. The clinical response rates of the first and sixth months were 72.5% and 62.5%, respectively. A total of 17/40 (42.5%) patients underwent colectomy within 1 year. In the patients who underwent colectomy, the basal LS (14.2 ± 1.9 vs 12.3 ± 1.7) (P = .002) was higher and the basal hemoglobin value (11.8 ± 2.3 vs 10.1 ± 1.5) (P = .037) was lower than those who did not undergo colectomy. CONCLUSION: Our findings suggest that cyclosporine treatment may be successfully and safely used in steroid refractory acute severe ulcerative colitis patients. Cyclosporine is a drug that has recently started to come up again with the introduction of new maintenance treatments. Especially in patients who develop a loss of response to infliximab therapy, or where infliximab therapy is contraindicated, or who have azathioprine intolerance, or are unresponsive.
BACKGROUND: Cyclosporine is a rescue treatment alternative to avoid colectomy in corticosteroid refractory acute severe ulcerative colitis. In this study, we aimed to evaluate the long-term efficacy and safety of cyclosporine therapy in acute severe ulcerative colitis patients. METHODS: Acute severe ulcerative colitis (basal Lichtiger score > 10) patients who did not respond to 40 mg intravenous methylpredniso- lone therapy after 3-5 days were included in the study. The presence of clinical response and remission was assessed at 1st week, 1st, 6th, and 12th month according to the Lichtiger index. RESULTS: In this study, 40 patients, whose steroid refractory acute severe ulcerative colitis and basal Lichtiger score > 10 points were enrolled. The median disease duration was 49.3 months (2-204). All patients received cyclosporine for 132 ± 78 days (7-270). Clinical response was obtained on seventh day in 82.5%. The clinical response rates of the first and sixth months were 72.5% and 62.5%, respectively. A total of 17/40 (42.5%) patients underwent colectomy within 1 year. In the patients who underwent colectomy, the basal LS (14.2 ± 1.9 vs 12.3 ± 1.7) (P = .002) was higher and the basal hemoglobin value (11.8 ± 2.3 vs 10.1 ± 1.5) (P = .037) was lower than those who did not undergo colectomy. CONCLUSION: Our findings suggest that cyclosporine treatment may be successfully and safely used in steroid refractory acute severe ulcerative colitis patients. Cyclosporine is a drug that has recently started to come up again with the introduction of new maintenance treatments. Especially in patients who develop a loss of response to infliximab therapy, or where infliximab therapy is contraindicated, or who have azathioprine intolerance, or are unresponsive.
Authors: G D'Haens; L Lemmens; K Geboes; L Vandeputte; F Van Acker; L Mortelmans; M Peeters; S Vermeire; F Penninckx; F Nevens; M Hiele; P Rutgeerts Journal: Gastroenterology Date: 2001-05 Impact factor: 22.682
Authors: Neeraj Narula; John K Marshall; Jean-Frederic Colombel; Grigorios I Leontiadis; John G Williams; Zack Muqtadir; Walter Reinisch Journal: Am J Gastroenterol Date: 2016-02-09 Impact factor: 10.864
Authors: Mark Löwenberg; Nicolette W Duijvis; Cyriel Ponsioen; Gijs R van den Brink; Paul Fockens; Geert R A M D'Haens Journal: Eur J Gastroenterol Hepatol Date: 2014-11 Impact factor: 2.566
Authors: Michael B Sternthal; Seamus J Murphy; James George; Asher Kornbluth; Simon Lichtiger; Daniel H Present Journal: Am J Gastroenterol Date: 2008-01-02 Impact factor: 10.864
Authors: John G Williams; M Fasih Alam; Laith Alrubaiy; Ian Arnott; Clare Clement; David Cohen; John N Gordon; A Barney Hawthorne; Mike Hilton; Hayley A Hutchings; Aida U Jawhari; Mirella Longo; John Mansfield; Jayne M Morgan; Frances Rapport; Anne C Seagrove; Shaji Sebastian; Ian Shaw; Simon P L Travis; Alan Watkins Journal: Lancet Gastroenterol Hepatol Date: 2016-09