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The use of ciclosporin in paediatric inflammatory bowel disease: an Italian experience

A Barabino1, F Torrente, E Castellano

  • 1Pediatric Gastroenterology, G Gaslini Institute, Genoa, Italy. abarab@tin.it

Alimentary Pharmacology & Therapeutics
|August 17, 2002
PubMed

Insights

Ciclosporin showed disappointing long-term efficacy for pediatric inflammatory bowel disease (IBD). However, it helped avoid urgent surgery in severe colitis cases, despite significant side effects like neurotoxicity.

Area of Science:

  • Pediatric Gastroenterology
  • Immunosuppressive Therapy

Background:

  • Inflammatory bowel disease (IBD) presents significant challenges in pediatric patients.
  • Refractory IBD cases often require novel therapeutic approaches.

Purpose of the Study:

  • To evaluate the efficacy and safety of ciclosporin in children with IBD.
  • To assess ciclosporin's role in managing severe, unresponsive, or fistulizing pediatric IBD.

Main Methods:

  • Retrospective study of 23 Italian children with IBD treated with ciclosporin.
  • Analysis of treatment duration, follow-up, and reasons for drug discontinuation.
  • Indications included severe colitis, chronic active colitis, and fistulizing Crohn's disease.

Main Results:

  • Ciclosporin was ineffective long-term for 39% of patients requiring surgery and 13% with partial response.
  • Clinical remission was achieved in 35% of patients, maintained in 17% after withdrawal.
  • Urgent colectomy was avoided in 85% of 14 patients with severe colitis.
  • Side effects occurred in 26% of patients, with neurotoxicity leading to discontinuation in 13%.

Conclusions:

  • Ciclosporin demonstrates limited long-term effectiveness for refractory pediatric IBD.
  • It plays a crucial role in preventing emergent surgery for severe, unresponsive colitis.
  • Significant adverse events, including neurotoxicity, necessitate careful monitoring.
Abstract

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