Cyclosporine treatment for inflammatory bowel disease

Article Abstract:

Crohn's disease and ulcerative colitis are both inflammatory bowel diseases. There is currently no effective way of curing Crohn's disease, although there are many theories on its cause. Treatment has generally been aimed at reducing the inflammation with anti-inflammatory drugs. The theory that Crohn's disease is caused by a hyperactive immune system has lead to two kinds of therapy. One suggests limiting the stimulation of the immune system by reducing exposure to antigens (foreign substances) with antibiotics, diet, feeding through intravenous injection of a prepared nutritional fluid (parenteral nutrition) or surgically diverting the digestive process from the intestines. Another method is to suppress the immune system with immunosuppressive drugs. A study by Brynskov has found that cyclosporine, a drug used to suppress the immune response during organ transplantation, offers symptom improvement for Crohn's disease. This therapy is particularly promising in patients who have had poor response with anti-inflammatory steroid treatment. There is some concern however, regarding the variations in the ability of different patients to absorb the drug, as well as the relapse rate and the toxicity of cyclosporine drugs. The use of cyclosporine is encouraging for the treatment of Crohn's disease and future studies on the action of the drug is suggested.

editorial

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A placebo-controlled, double-blind, randomized trial of cyclosporine therapy in active chronic Crohn's disease

Article Abstract:

Crohn's disease is a chronic inflammation or swelling of the intestines which causes diarrhea, pain, nausea, weight loss and loss of appetite. In most patients the symptoms are mild (75 percent), but in some the disease can be severe. It has been suggested that the disease may be caused by a defect that causes the immune system to become overactive. Treatment with anti- inflammatory drugs, steroids, usually offers some relief, but in some patients this therapy does not work or is not well tolerated. Cyclosporine, a drug used to suppress the immune system in organ transplant patients, was given to 71 patients for whom steroid therapy was not an option. After a three-month period, 59 percent of the patients receiving cyclosporine and 32 percent of the patients receiving a placebo had improved symptoms when measured by the Crohn's disease activity index. When the treatment was withdrawn, 38 percent of the cyclosporine-treated group maintained improved symptoms, compared with 15 percent in the placebo group. The use of cyclosporine for the treatment of chronic Crohn's disease offered symptom improvement, but long-term studies are needed.

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A comparison of budesonide and mesalamine for active Crohn's disease

Article Abstract:

A controlled-release form of the drug budesonide appears to be more effective in treating Crohn's disease than slow-release mesalamine. Crohn's disease is an inflammatory bowel disease. Researchers randomly assigned 182 patients with Crohn's disease to receive controlled-release budesonide or slow-release mesalamine. Remission rates were consistently higher in the budesonide group compared to the mesalamine group. More patients in the budesonide group completed treatment, most likely because this drug had fewer severe side effects.

Evaluation, Budesonide, Mesalamine

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