Alimentary TractIntravenous cyclosporine versus intravenous corticosteroids as single therapy for severe attacks of ulcerative colitis☆
Section snippets
Patient selection and eligibility
This single-center prospective, double-blind, controlled randomized trial compared the efficacy of IV glucocorticosteroids with that of cyclosporine, both given as single IV therapy in continuous infusion for 8 days. Patients were between the ages of 18 and 70 years and were hospitalized with a severe attack of UC. All patients had undergone colonoscopy showing UC extending at least to the splenic flexure at an earlier stage. On the day of inclusion or on the day before, a flexible
Patient characteristics and response to treatment
From January 1997 to July 1998, 30 sequential patients presenting at the emergency room and the outpatient clinic who met the inclusion criteria were asked to take part in this trial; none refused to do so. Fifteen patients were treated with methylprednisolone and 15 with cyclosporine in random order. Patient characteristics are shown in Table 2.Characteristic Cyclosporine group Methylprednisolone group P n 15 15 Mean age, yr (range) 36.7 ± 2.8
Discussion
In this trial we found that IV cyclosporine was at least as effective as IV glucocorticosteroids for severe attacks of UC. The mean time to response with cyclosporine was comparable to that observed in other trials, in which cyclosporine was administered in combination with glucocorticosteroids and in which even longer treatments (up to 14 days) were given.7, 9 Clinical improvement after 8 days was not always accompanied by an endoscopic and histologic response. Mucosal healing and
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Address requests for reprints to: Geert R. D'Haens, M.D., Ph.D., Department of Internal Medicine, University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium. e-mail: [email protected]; fax: (32) 16-34-42-99.