Long‐term outcome of cyclosporin rescue therapy in acute, steroid‐refractory severe ulcerative colitis

Molnár, Tamás; Farkas, Klaudia; Szepes, Zoltán; Nagy, Ferenc; Szűcs, Mónika; Nyári, Tibor; Bálint, Anita; Wittmann, Tibor

doi:10.1177/2050640614520865

Cited by 12 publications

(10 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While the duration of optimal therapy is yet to be established, in a retrospective study, Molnar et al . found that treatment for 1 year correlated with a 66% probability of avoiding colectomy at 4‐year follow‐up and beyond . Further prospective studies are needed to confirm this association.…”

Section: Salvage Therapiesmentioning

confidence: 93%

“…There has been recent suggestion that more extended durations of therapy may enhance greater durability of remission and improve rates of colectomy‐free survival . While the duration of optimal therapy is yet to be established, in a retrospective study, Molnar et al .…”

Section: Salvage Therapiesmentioning

confidence: 99%

“…Ciclosporin should be avoided in patients who have relapsed with optimal thiopurine maintenance therapy, those with hypocholesterolaemia and poor renal function, and those affected by active infection or recent immunosuppression secondary to recent infliximab infusion. Treatment with ciclosporin may be associated with potentially serious side effects including renal failure, neurotoxicity (seizures), anaphylaxis and infectious complications, thereby limiting it use as long‐term therapy . Randomised controlled trials have reported mortality rates between 0% and 5% …”

Section: Salvage Therapiesmentioning

confidence: 99%

“…There has been recent suggestion that more extended durations of therapy may enhance greater durability of remission and improve rates of colectomy-free survival. 60 While the duration of optimal therapy is yet to be established, in a retrospective study, Molnar et al found that treatment for 1 year correlated with a 66% probability of avoiding colectomy at 4-year follow-up and beyond. 31,60 Further prospective studies are needed to confirm this association.…”

Section: Salvage Therapiesmentioning

confidence: 99%

See 3 more Smart Citations

Review article: the practical management of acute severe ulcerative colitis

Seah

Cruz

2016

Aliment Pharmacol Ther

View full text Add to dashboard Cite

Review: practical management of acute severe ulcerative colitis excluded if patients had a subsequent diagnosis of Crohn's disease or indeterminate colitis. PREDICTING DISEASE COURSE AND REQUIREMENT FOR SALVAGE THERAPYOptimal management of ASUC relies on timely and repeated evaluation of disease response to therapy, in order to improve clinical outcomes. One of the major challenges faced by clinicians is the absence of a widely accepted management and monitoring protocol. 11,12 In particular, three key stages of assessment in the acute setting have been investigated in the literature: (i) on admission, (ii) after initiation of steroid therapy and (iii) after initiation of salvage therapy. More recently, studies have also focussed on long-term outcomes; however, further prospective studies in this area are required. Steroid therapy

show abstract

Section: Salvage Therapiesmentioning

confidence: 93%

Section: Salvage Therapiesmentioning

confidence: 99%

Section: Salvage Therapiesmentioning

confidence: 99%

Section: Salvage Therapiesmentioning

confidence: 99%

See 2 more Smart Citations

Review article: the practical management of acute severe ulcerative colitis

Seah

Cruz

2016

Aliment Pharmacol Ther

View full text Add to dashboard Cite

show abstract

“…Although there are several medications on the market for IBD, they generally only provide temporary relief, and 70% of IBD patients require surgical intervention (2). Because the current treatments are not satisfactory, new drug leads are being sought from a range of sources, including small molecules from plants and bioactive regions of larger proteins (3)(4)(5)(6).…”

mentioning

confidence: 99%

An engineered cyclic peptide alleviates symptoms of inflammation in a murine model of inflammatory bowel disease

Caceres

Bansal

Navarro

et al. 2017

Journal of Biological Chemistry

View full text Add to dashboard Cite

Edited by Wolfgang PetiInflammatory bowel diseases (IBDs) are a set of complex and debilitating diseases for which there is no satisfactory treatment. Recent studies have shown that small peptides show promise for reducing inflammation in models of IBD. However, these small peptides are likely to be unstable and rapidly cleared from the circulation, and therefore, if not modified for better stability, represent non-viable drug leads. We hypothesized that improving the stability of these peptides by grafting them into a stable cyclic peptide scaffold may enhance their therapeutic potential. Using this approach, we have designed a novel cyclic peptide that comprises a small bioactive peptide from the annexin A1 protein grafted into a sunflower trypsin inhibitor cyclic scaffold. We used native chemical ligation to synthesize the grafted cyclic peptide. This engineered cyclic peptide maintained the overall fold of the naturally occurring cyclic peptide, was more effective at reducing inflammation in a mouse model of acute colitis than the bioactive peptide alone, and showed enhanced stability in human serum. Our findings suggest that the use of cyclic peptides as structural backbones offers a promising approach for the treatment of IBD and potentially other chronic inflammatory conditions. Inflammatory bowel diseases (IBDs)3 are a set of chronic inflammatory disorders of the gastrointestinal tract; the two major forms are ulcerative colitis and Crohn's disease (1). Although there are several medications on the market for IBD, they generally only provide temporary relief, and 70% of IBD patients require surgical intervention (2). Because the current treatments are not satisfactory, new drug leads are being sought from a range of sources, including small molecules from plants and bioactive regions of larger proteins (3-6).Intriguingly, several small peptides, some comprising only three residues, have been shown to be effective in the treatment of experimental colitis in mice (7-11). One example is a tripeptide (MC-12) derived from annexin A1, a calcium-dependent phospholipid-binding, anti-inflammatory protein (12). Annexin A1 mediates expression of cytokines such as TNF-␣, IL-6, and IL-10. It is required for the inhibition of NF-B activity by anti-inflammatory drugs (13) and has recently been shown to be a potential biomarker of therapeutic efficacy for IBD (14). The N-terminal region of annexin A1 comprising residues 2-26 (Ac2-26) has been well studied (15, 16) and appears to have the same biological effects as the full-length protein (17). Analysis of a series of peptides based on the N-terminal sequence of annexin A1 showed that MC-12 (Ac-Gln-Ala-Trp) was the most potent inhibitor of NF-B activity in SW480 cells (13).Small peptides such as MC-12 are likely to be unstable and not viable drug leads, supported by the finding that high doses (25 mg/kg) of MC-12 were required to elicit an in vivo response in mouse colitis models, and it was more effective when injected compared with oral administration (18). Improving t...

show abstract

Zastosowanie cyklosporyny A we wrzodziejącym zapaleniu jelita grubego i autoimmunizacyjnym zapaleniu wątroby u dzieci

2016

View full text Add to dashboard Cite

Long‐term outcome of cyclosporin rescue therapy in acute, steroid‐refractory severe ulcerative colitis

Abstract: Cyclosporin is effective in acute, severe UC during long-term follow up. Our data suggest that the longer cyclosporin is used, the more it is possible to avoid colectomy in the future.

Cited by 12 publications

References 12 publications

Review article: the practical management of acute severe ulcerative colitis

Review article: the practical management of acute severe ulcerative colitis

An engineered cyclic peptide alleviates symptoms of inflammation in a murine model of inflammatory bowel disease

Zastosowanie cyklosporyny A we wrzodziejącym zapaleniu jelita grubego i autoimmunizacyjnym zapaleniu wątroby u dzieci

Contact Info

Product

Resources

About