BACKGROUND: Intravenous @entity205 is the only new therapy in recent years to have made a significant impact on the management of acute severe @entity31 ( @entity31 ). It is increasingly recommended for use in @entity1 who prove refractory to the standard regimen of intravenous (i.v.) and rectal @entity701 but do not warrant immediate surgery. This practice is based on uncontrolled and controlled studies which suggest a short-term efficacy of 80% and long-term efficacy of 60% in avoiding colectomy. AIM: The aim of this study was to assess the short- and long-term efficacy of i.v. @entity205 in @entity1 admitted to our hospital with acute severe @entity31 refractory to i.v. @entity230 , over a 6-year period. METHOD: A retrospective survey of @entity1 admitted to the John Radcliffe Hospital, Oxford, with acute severe @entity31 over a 6-year period (1991-97) was performed. Truelove and Witts criteria for acute severe @entity31 were satisfied by 216 @entity1 . RESULTS: The standard regimen achieved remission in 132 @entity1 (61%). Of the 84 @entity1 who failed to respond, 34 (40%) proceeded directly to colectomy whilst 50 received @entity205 (4 mg/kg by continuous slow infusion). Remission was achieved by i.v. @entity205 in 28/50 (56%) @entity1 who were subsequently transferred to oral @entity205 (5 mg/kg). However, 8/28 (29%) who initially responded later relapsed after discharge from hospital and underwent colectomy. The short-term efficacy of 56% therefore falls to 40% in the longer term (mean follow-up of 19 months). CONCLUSION: This is the largest survey to date of @entity1 with refractory severe @entity31 treated with i.v. @entity205 . The findings confirm the potential value of i.v. @entity205 in severe @entity31 but its effectiveness in clinical practice is less dramatic than previously reported.

Intravenous @entity205 as rescue therapy in severe XXXX : time for a reappraisal?

@entity1 :: ('9606', 'Species') :: ['patients'] @entity31 :: ('MESH:D003093', 'Disease') :: ['ulcerative colitis', 'UC'] @entity205 :: ('MESH:D016572', 'Chemical') :: ['cyclosporin'] @entity701 :: ('MESH:D006854', 'Chemical') :: ['hydrocortisone'] @entity230 :: ('MESH:D013256', 'Chemical') :: ['steroids']
@entity31 :: (MESH:D003093,Disease) :: ['ulcerative colitis']
