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The use of ciclosporin in paediatric inflammatory bowel disease: an Italian experience
Author(s) -
Barabino A.,
Torrente F.,
Castellano E.,
Gandullia P.,
Calvi A.,
Cucchiara S.,
De 'Angelis G. L.,
Fontana M.,
Lionetti P.,
De Giacomo C.,
Gissi A.
Publication year - 2002
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.2002.01308.x
Subject(s) - medicine , ciclosporin , discontinuation , inflammatory bowel disease , colectomy , colitis , refractory (planetary science) , surgery , chemotherapy , gastroenterology , disease , ulcerative colitis , physics , astrobiology
Summary Aim : To asses the efficacy and safety of ciclosporin in a paediatric population with inflammatory bowel disease. Patients and methods : Twenty‐three Italian children treated with ciclosporin were studied retrospectively. The indications for treatment were severe unresponsive colitis, chronic active colitis or severe fistulizing Crohn's disease. The treatment duration, follow‐up and causes of drug discontinuation were assessed. Results : Sixteen patients were treated intravenously for a mean time of 10 ± 7 days (1–24 days) and 19 orally for a mean time of 133 days (17–660 days). The mean follow‐up of all patients was 13.2 months. Ciclosporin was totally ineffective, being discontinued for surgery, in nine of 23 patients (39%); it was discontinued for partial response in three patients (13%). During treatment, clinical remission was achieved in eight children (35%) and maintained after drug withdrawal in four (17%). In severe unresponsive colitis, urgent colectomy was avoided in 12 (85%) of 14 patients who tolerated the drug. Side‐effects appeared in six of 23 patients (26%), and three (13%) required ciclosporin to be discontinued due to neurotoxicity. Conclusions : Ciclosporin shows disappointing long‐term results in the treatment of refractory inflammatory bowel disease, but can play an important role in preventing urgent surgery in unresponsive severe colitis. Severe side‐effects can occur.