Low‐dose oral microemulsion ciclosporin for severe, refractory ulcerative colitis

Saussure, Philippe de; Soravia, Claudio; Morel, P; Hadengue, Antoine

doi:10.1111/j.1365-2036.2005.02552.x

Cited by 20 publications

(7 citation statements)

References 36 publications

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“…This result has been confirmed by several retrospective and prospective studies [105][106][107][108][109][110]. Oral CsA is also effective for refractory UC patients and the response rate was approximately 70-80% [111,112]. Oral microemulsion CsA for severe, steroid-refractory UC achieves an efficacy similar to intravenous CsA, and it could potentially substitute intravenous CsA [111].…”

Section: Calcineurin Inhibitorsmentioning

confidence: 78%

“…Oral CsA is also effective for refractory UC patients and the response rate was approximately 70-80% [111,112]. Oral microemulsion CsA for severe, steroid-refractory UC achieves an efficacy similar to intravenous CsA, and it could potentially substitute intravenous CsA [111]. The long-term prognosis of UC patients treated with CsA has also been reported [105][106][107][108][109][110].…”

Section: Calcineurin Inhibitorsmentioning

confidence: 99%

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Ulcerative colitis: prevention of relapse

Sakuraba

Hibi

2013

Expert Review of Gastroenterology & Hepatology

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The clinical management of ulcerative colitis (UC) involves first treating the acute symptoms to induce remission, and then successfully maintaining it. Oral 5-aminosalicylic acids are safe and useful for maintaining remission in patients with UC. In terms of adherence, a once-daily form of 5-aminosalicylic acid is superior in maintaining remission as compared with split dosing. Patients at high risk of relapse may be candidates for treatment with thiopurines and/or biologics in the early stages of UC. Calcineurin inhibitors, such as cyclosporine and tacrolimus, are effective for severe, steroid-refractory UC patients. It is suggested that these patients use thiopurines as their maintenance therapy once they achieve remission with calcineurin inhibitors. Recent studies have confirmed that biologics are effective for inducing clinical and endoscopic remission of UC, and thus they may improve long-term prognosis of UC.

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Section: Calcineurin Inhibitorsmentioning

confidence: 78%

Section: Calcineurin Inhibitorsmentioning

confidence: 99%

Ulcerative colitis: prevention of relapse

Sakuraba

Hibi

2013

Expert Review of Gastroenterology & Hepatology

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“…In case of response to intravenous treatment, a relay by oral ciclosporin is then undertaken. Some teams proposed out of hand oral micro-emulsion treatment with ciclosporin (Neoral®), at an initial dose of 2 mg/kg per 12 hours and the objective of a circulating residual rate around 100 ng/ml and a peak (2 hours after taking the drug) close to 600 ng/ml [19] [20]. In our study ciclosporin was administered orally given the unavailability of the intravenous form in Morocco with an initial response rate of 66% which is concord with the results of the literature.…”

Section: Monterubbianesi Et Al Reported In a Study Involving 113 Patmentioning

confidence: 99%

Evolutionary Profile of Severe Acute Ulcerative Colitis in Chronic Inflammatory Bowel Diseases

Abid¹,

Babakhouya²,

Mellouki³

et al. 2018

OJGas

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Background: Severe acute colitis is a common complication of inflammatory bowel disease (IBD). Their diagnosis is based on clinical, laboratory, endoscopic and radiological. The severe acute colitis is a medical and surgical emergency; its mortality is 1% to 3%. The management should be swift and coordinated, upon admission, between medical and surgical teams. Methods: This is a retrospective study in Gastroenterology Service at the University Hospital HASSAN II Fez, over a period of 10 years (2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015). We included all patients admitted for severe acute colitis; all the epidemiological, clinical, endoscopic, histological, and therapeutic monitoring of patients were collected. Results: We collected 123 patients. Their average age was 35 years (16 -70). It was a female predominance (sex ratio F/M = 1.19). 54 patients were admitted for an inaugural severe acute colitis (43%), while 69 patients were known carriers of IBD (56%). All patients were admitted to an array of severe acute colitis according to the criteria of Truelove and Witts modified. 9 patients were operated urgently because there was the presence of complications (5 cases of perforation, 3 cases of massive rectal bleeding, and one patient with an abscess in the right iliac fossa). Corticosteroids intravenously was administered to 114 patients, 74 patients (64%) had remission. Patients who have not responded to corticosteroids IV (N = 40): 1) 12 patients received treatment with oral cyclosporine: the remission rate was 66%. 2) 8 patients were put under Infliximab: The response rate was 75%. 3) Patients who have not responded to a second-line treatment underwent subtotal colectomy with a dual stoma. 4) The surgery was indicated as a second-line treatment in 20 patients who all received a subtotal colectomy with double stoma; totalizing colectomy and ileoanale anastomosis ware made in 4 patients. The mortality rate is higher in our series (12%) mainly postoperatively; it is due to the delayed admission of patients, which promotes the development of complications. Conclusion: Acute Severe Ulcerative Colitis is a medical and surgical emergency

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“…Environ trois malades sur quatre répondent à court terme et 40 % répondent à long terme. Des résultats similaires sont obtenus avec le Néoral ® [36,37], avec une dose initiale de 2 à 2,5 mg/kg par 12 heures et une ciclosporinémie cible de 100 ng/ml à jeun et 500 à 700 ng/ml deux heures après la prise du Néoral ® du matin. La toxicité de la ciclosporine est importante.…”

Section: Utilisation Pratiqueunclassified

Traitement médical de la RCH grave: lesquels et jusqu’où?

Carbonnel

2008

Colon Rectum

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Une poussée sévère de rectocolite hémorragique doit être traitée par la colectomie en urgence dans les formes compliquées et par une corticothérapie intraveineuse dans les autres situations. En cas de corticorésistance, la ciclosporine ou l'infliximab peuvent être proposés. La colectomie est recommandée en cas d'échec du traitement de première ou deuxième ligne selon les cas. Les stratégies médicamenteuses de troisième ligne ou les associations d'immunosuppresseurs ne sont ni validées ni recommandées.Abstract: Severe ulcerative colitis must be treated by emergency colectomy for complicated forms, and with intravenous steroids in other situations. When steroids have failed, ciclosporin or infliximab may be tested. Colectomy is mandatory in case of failure of first or second line therapy. Third line drug strategies or combined immunosuppressive therapies are not recommended.

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Low‐dose oral microemulsion ciclosporin for severe, refractory ulcerative colitis

Cited by 20 publications

References 36 publications

Ulcerative colitis: prevention of relapse

Ulcerative colitis: prevention of relapse

Evolutionary Profile of Severe Acute Ulcerative Colitis in Chronic Inflammatory Bowel Diseases

Traitement médical de la RCH grave: lesquels et jusqu’où?

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