Immunosuppressive drugs in ulcerative colitis: twisting facts to suit theories?

Sands, B. E.
April 2006
Gut;Apr2006, Vol. 55 Issue 4, p437
Academic Journal
Immunosuppressive drugs have become a mainstay of therapy far the inflammatory bowel diseases, Although robust evidence exists in support of the use of these drugs in Crohn's disease, a close evaluation of the available data in ulcerative colitis reveals a much weaker evidence base. In particular, randomised controlled trials of azathioprine, the most commonly used immunosuppressive agent, do not provide rich evidence of efficacy whereas observational cohorts suggest this agent is effective, particularly in patients with relapsing disease !ho require corticosteroids. Ciclosporin is also effective in the most refractory cases hut its efficacy needs to be carefully weighed against the possibility of rare but life threatening complications. Although the evidence base in support of immunosuppressive drugs in ulcerative colitis is not as strong as in Crohn's disease, these agents clearly have a role in the treatment of this disease.


Related Articles

  • Immunosuppressant Medications and Mortality in Inflammatory Bowel Disease. Lewis, James D.; Gelfand, Joel M.; Troxel, Andrea B.; Forde, Kimberly A.; Newcomb, Craig; Kim, Hopiy; Margolis, David J.; Strom, Brian L. // American Journal of Gastroenterology;Jun2008, Vol. 103 Issue 6, p1428 

    OBJECTIVE: This study examined whether treatment of Crohn's disease (CD) and ulcerative colitis (UC) with immunosuppressant medications was associated with an increased risk of death in the era prior to antitumor necrosis factor (TNF) therapies. DESIGN: This retrospective cohort study used data...

  • Can Calprotectin Predict Relapse Risk in Inflammatory Bowel Disease? D'Inc, Renata; Dal Pont, Elisabetta; Di Leo, Vincenza; Benazzato, Luca; Martinato, Matteo; Lamboglia, Francesca; Oliva, Lydia; Carlo Sturniolo, Giacomo // American Journal of Gastroenterology;Aug2008, Vol. 103 Issue 8, p2007 

    OBJECTIVE: Assessing the clinical course of inflammatory bowel disease (IBD) patients consists of periodical clinical evaluations and laboratory tests. We aimed to assess the role of calprotectin tests in predicting clinical relapse in IBD patients. METHODS: Ninety-seven patients with ulcerative...

  • Immunization status in children with inflammatory bowel disease. Longuet, Romain; Willot, Stephanie; Giniès, Jean-Louis; Pélatan, Cecile; Breton, Estelle; Segura, Jean-François; Bridoux, Laure; Henaff, Gaelle; Cagnard, Benoit; Jobert, Agathe; Cardonna, Joël; Grimal, Isabelle; Balençon, Martine; Darviot, Estelle; Delaperrière, Nadège; Caldari, Dominique; Piloquet, Hugues; Dabadie, Alain // European Journal of Pediatrics;May2014, Vol. 173 Issue 5, p603 

    Inflammatory bowel diseases have an increased risk of infections due to immunosuppressive therapies. To report the immunization status according to previous recommendations and the reasons explaining a delay, a questionnaire was filled in by the pediatric gastroenterologist, concerning...

  • New pathophysiological insights and modern treatment of IBD. Engel, Matthias A.; Neurath, Markus F. // Journal of Gastroenterology;Jun2010, Vol. 45 Issue 6, p571 

    Inflammatory bowel disease (IBD), which comprises two main types, namely, Crohn’s disease and ulcerative colitis, affects approximately 3.6 million people in the USA and Europe, and an alarming rise in low-incidence areas, such as Asia, is currently being observed. In the last decade,...

  • Current use of immunosuppressive agents in inflammatory bowel disease patients in East China. Li-Juan Huang; Qin Zhu; Min Lei; Qian Cao; Cario, Elke // World Journal of Gastroenterology;6/28/2009, Vol. 15 Issue 24, p3055 

    AIM: To investigate immunosuppressive agents used to treat inflammatory bowel disease (IBD) in East China. METHODS: A retrospective review was conducted, involving 227 patients with IBD admitted to Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University from June 2000 to December...

  • Digestive Disease Week 2011: An Update on IBD Clinical Research. Hoentjen, Frank // Inflammatory Bowel Disease Monitor;2011, Vol. 12 Issue 1, p42 

    Information about several papers discussed at a meeting held May 7-10, 2011 sponsored by University of Chicago Department of Medicine on biological therapy for inflammatory bowel disease (IBD) is presented. Topics include immunosuppressive therapy for patients with Crohn's disease, the use of...

  • A 6-Thioguanine Nucleotide Threshold Level of 400 pmol/8 × 108 Erythrocytes Predicts Azathioprine Refractoriness in Patients With Inflammatory Bowel Disease and Normal TPMT Activity. Roblin, Xavier; Biroulet, Laurent P.; Phelip, Jean M.; Nancey, Stéphane; Flourie, Bernard // American Journal of Gastroenterology;Dec2008, Vol. 103 Issue 12, p3115 

    BACKGROUND AND AIMS: A therapeutic level of 6-thioguanine nucleotides (6-TGN) has been reported in inflammatory bowel disease (IBD) patients under azathioprine (AZA). We investigated the threshold value of 6-TGN that may be predictive of AZA refractoriness and its impact on safety...

  • Use of mycophenolate mofetil in inflammatory bowel disease. Tan, Terrence; Lawrance, Ian Craig; Koutroubakis, Ioannis E. // World Journal of Gastroenterology;4/7/2009, Vol. 15 Issue 13, p1594 

    AIM: To assess the efficacy and safety of mycophenolate mofetil (MMF) prospectively in inflammatory bowel disease (IBD) patients intolerant or refractory to conventional medical therapy. METHODS: Crohn's disease (CD) or ulcerative colitis/IBD unclassified (UC/IBDU) patients intolerant or...

  • Cyclosporine and inflammatory bowel disease: buying time. Meijssen, M. A. C. // Mediators of Inflammation;Jun98, Vol. 7 Issue 3, p145 

    CYCLOSPORINE is an effective drug in acute exacerbations of corticosteroid resistant ulcerative colitis, but its efficacy to maintain disease remission is not clear. Cyclosporine may not be as effective in Crohn's disease. However, being a rapidly acting immunosuppressant, cyclosporine may be a...


Read the Article


Sign out of this library

Other Topics