Original articleIncidence of Colectomy During Long-term Follow-up After Cyclosporine-Induced Remission of Severe Ulcerative Colitis
Section snippets
Patients and Treatment Regimen
The medical charts and progress notes of all patients admitted to the Gastroenterology Department of the university hospital of Leuven (Belgium) with a severe attack of UC who were treated with IV CSA between November 1992 and October 2004 were included in the study. This study was an extension of the study performed by Arts et al.10 For patient identification we used the pharmacy records. Before treatment with IV CSA was initiated all patients were treated with IV glucocorticosteroids
Patient Demographics
A total of 142 (65 female, 46%) patients were identified and records for all patients were recovered. The mean age of the patients was 41 years (range, 16–76 y). The mean duration of IV CSA was 9.3 days. The mean duration of oral CSA therapy of the responders to IV CSA was 97 days.
Short-term Response to Intravenous Cyclosporine
A total of 118 of the initial 142 (81%) patients had a response to IV CSA and avoided colectomy during their initial hospitalization. Of these 118 patients, 20 achieved a partial response to CSA and continued to
Discussion
CSA is effective in inducing remission in patients with severe UC. We report an 81% response to IV CSA. Our short-term results that suggest that 48% of patients avoid colectomy at 3 years are similar to other reports.9, 12 Novel data in this study, however, indicate that at 7 years only 12% of patients remain colectomy free. Furthermore, in those patients who have avoided colectomy, 48% are symptomatic at 3 years, with 82% being symptomatic at 7 years. This suggests that a significant majority
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