[Cyclosporine in inflammatory bowel disease]

Inflammatory Bowel Disease (IBD), as Ulcerative Colitis (UC) as well as Crohn's Disease (CD), can appear as severe outbreak resistant to steroid treatment. These cases require surgery or immunosupressive therapy (mercaptopurine or azathioprine). Cyclosporine A (CYA) is a selective, reversible immunosupressor of the T helper lymphocites, used in the treatment of organ transplants and in certain autoimmune diseases. CYA is not a first line therapy for IBD. In spite of the positive results obtained in some uncontrolled studies, only one randomized trial has shown the superiority of CYA over the placebo in the treatment of UC and avoided colectomy in one third of the patients with the severe form of this disease. It can also contribute to the healing of resistault CD fistulaes. The potential toxicity of CYA and the few controlled clinical trials limit its use. However CYA needs to define its role in the treatment of IBD through II more controlled trials.