Role of Cyclosporine for the Treatment of IBD in the Biological Era

Abstract

About 30% of the patients with acute, severe ulcerative colitis (UC) do not respond to corticosteroids and require surgery or alternative medical therapy. Cyclosporine (CsA) and infliximab (IFX) are two potential choices as rescue therapies in the treatment of acute, severe UC. CsA is one of the most effective therapeutic choices in patients with severe UC; however, long term colectomy rate still varies between 60-88% among patients in whom CsA initially induced remission. IFX also proved to reduce short and long-term colectomy rates among steroid-refractory UC patients. This aim of this review is to summarize the results of the published studies examining the long-term results of CsA and IFX as rescue therapies, comparing their efficacy in steroid refractory UC and assessing the benefit of switching the drugs in case of therapeutic failure.