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[Chronic active ulcerative colitis. Efficacy of intravenous followed by oral cyclosporine combined with azathioprine]

AbstractOBJECTIVE: To know whether the therapeutic protocol applied in the case of severe acute ulcerative colitis (UC) associating ciclosporine and azathioprine was also effective in the case of moderate chronic active ulcerative colitis (UC). SUBJECTS AND METHODS: in this retrospective study 10 patients (31-65 years, 6 distal colitis, 1 left colitis, 3 pancolitis) moderately active and corticosteroid-resistant or dependent were included. Patients received ciclosporine intraveinously (4 mg/kg/d) and were evaluated 10 days later. If efficient, ciclosporine was given orally for 3 Months, azathioprine was introduced and steroids were progressively tapered. RESULTS: on inclusion the clinical score, based on the Mayo Clinic score, was of 5.7 +/- 0.5. On Day 10, the score decreased significantly (2.1 +/- 0.7, p<0.001) and the therapeutic effect was sustained at the third Month (1.8 +/- 0.7). With azathioprine, 4 patients were still in remission with a mean follow up of 23.3 +/- 15.5 Months. CONCLUSION: therapeutic scheme proposed in severe acute UC failing to respond to steroids may be helpful in some patients with a chronic active UC. Clinical improvement is rapid and long-term response is maintained in about 1 patient out of 2.
AuthorsDriffa Moussata, Stéphane Nancey, Bernard Flourié, Sylvette Claudel Bonvoisin, Jean-Claude Cenni, Louis Descos (Affiliation: Unité Inserm 407, Faculté de médecine Lyon Sud, Oullins. driffamme at aol.com)
JournalPresse médicale (Paris, France : 1983) (Presse Med) Vol. 33 Issue 9 Pt 1 Pg. 590-4 (May 22 2004) ISSN: 0755-4982 France
Vernacular TitleRectocolite ulcéro-hémorragique chronique active. Efficacité de la ciclosporine intra-veineuse puis orale, associée à l'azathioprine.
PMID15226690 (Publication Type: English Abstract, Journal Article)
Chemical References
  • Immunosuppressive Agents
  • Azathioprine
  • Cyclosporine
Topics
  • Acute Disease
  • Administration, Oral
  • Adult
  • Aged
  • Attitude of Health Personnel
  • Attitude to Health
  • Azathioprine (administration & dosage)
  • Chronic Disease
  • Colitis, Ulcerative (classification, diagnosis, drug therapy, psychology)
  • Cyclosporine (administration & dosage)
  • Drug Administration Schedule
  • Drug Monitoring
  • Drug Therapy, Combination
  • Female
  • Humans
  • Immunosuppressive Agents (administration & dosage)
  • Infusions, Intravenous
  • Male
  • Middle Aged
  • Remission Induction (methods)
  • Retrospective Studies
  • Severity of Illness Index
  • Time Factors
  • Treatment Outcome