Document Detail


Cyclosporine treatment of steroid-refractory ulcerative colitis during pregnancy.
MedLine Citation:
PMID:  19137604     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cyclosporine is considered a safe and effective treatment of severe steroid-refractory ulcerative colitis (UC). However, few data are available concerning its safety profile in pregnant women. We report here the experience of 5 GETAID centers. METHODS: In a retrospective study data on patients with severe UC treated with cyclosporine during pregnancy were extracted from medical records of consecutive patients treated between 2001 and 2007. RESULTS: Eight patients (median age 30.5 years old) were identified. At the time of flare-up the median duration of pregnancy was 11.5 weeks of gestation (range 4-25). Seven patients had pancolitis. All patients had more than 3 commonly used clinical and biological severity criteria. Three patients had severe endoscopic lesions and 5 patients had not. All patients received intravenous corticosteroids for at least 7 days before introduction of cyclosporine. Two patients received azathioprine during treatment with cyclosporine. No severe infections or other complications due to treatment were observed. Treatment was effective in 7/8 patients. One patient received infliximab due to cyclosporine therapy failure with a good outcome. No colectomy was performed during pregnancy. Seven pregnancies were conducted to term, but 1 in utero death occurred due to maternal absence of S-protein. Two newborns were premature, including 1 case of hypotrophy. No malformations were observed. CONCLUSIONS: In our experience, treatment with cyclosporine for steroid-refractory UC during pregnancy can be considered safe and effective.
Authors:
Julien Branche; Antoine Cortot; Arnaud Bourreille; Benoît Coffin; Martine de Vos; Philippe de Saussure; Philippe Seksik; Philippe Marteau; Marc Lemann; Jean-Frédéric Colombel
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Inflammatory bowel diseases     Volume:  15     ISSN:  1536-4844     ISO Abbreviation:  Inflamm. Bowel Dis.     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-06-16     Completed Date:  2009-09-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9508162     Medline TA:  Inflamm Bowel Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1044-8     Citation Subset:  IM    
Affiliation:
Service des Maladies de l'Appareil Digestif et de la Nutrition, Hôpital Huriez, CHU Lille, Lille, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Colitis, Ulcerative / drug therapy*
Cyclosporine / administration & dosage*,  adverse effects
Drug Resistance
Female
Follow-Up Studies
Humans
Immunosuppressive Agents / administration & dosage*,  adverse effects
Pregnancy
Pregnancy Complications / drug therapy*
Pregnancy Outcome*
Retrospective Studies
Severity of Illness Index
Steroids / therapeutic use
Chemical
Reg. No./Substance:
0/Immunosuppressive Agents; 0/Steroids; 59865-13-3/Cyclosporine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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