INTESTINE Vol.15 No.3(2-4)

Theme Therapeutic strategy for ulcerative colitis ; from standard to up-to-date
Title Efficacy and positioning of intravenous cyclosporine therapy for patients with severe steroid refractory ulcerative colitis
Publish Date 2011/05
Author Naoki Yoshimura Department of Internal Medicine, Division of IBD, Social Insurance Central General Hospital
Author Masakazu Takazoe Department of Internal Medicine, Division of IBD, Social Insurance Central General Hospital
[ Summary ] Recently, the immunosuppressive agent, cyclosporineA (CsA) has been introduced as an alternative medication for patients with severe corticosteroid refractory ulcerative colitis (UC). Up to 80 % of patients with severe UC refractory to corticosteroid are known to respond to CsA, potentially avoiding colectomies. It would appear that rates of remission in patients with severe UC have improved with this treatment. However, the enthusiasm for CsA is dampened by high relapse rates following remission induction. Nevertheless, for CsA therapy, prior assessment of the efficacy of current Ⅳ steroid administration should be conducted, immediately, followed by CsA therapy. Further, infusion of infliximab, which is now an approved medication for UC, may benefit patients who show inadequate response to CsA. This strategy is expected to contribute to better prognoses after CsA induced remission and improve patients' quality of life.
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