Role of endoscopic ultrasonography in predicting the response to cyclosporin A in ulcerative colitis refractory to steroids

O Watanabe, T Ando, E M El-Omar, M Shimada, K Ina, K Ishiguro, M Hasegawa, N Miyake, M Nakamura, R Miyahara, N Ohmiya, Y Niwa, H Goto

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

BACKGROUND AND AIMS: Although cyclosporin A has been reported to be effective in the treatment of severe ulcerative colitis, factors predicting its therapeutic efficacy remain unclear. Technical progress in endoscopic ultrasonography has improved visualisation of the structure of the colon wall. Here, to assess the value of endoscopic ultrasonography in predicting the response to cyclosporin A treatment, we evaluated the therapeutic effect of cyclosporin A by determining the pre- and post-cyclosporin A thickness of the mucosal layer in the rectum using endoscopic ultrasonography with an ultrasonic catheter probe. PATIENTS AND METHODS: Fifteen ulcerative colitis patients who did not respond to high-doses of corticosteroids were treated with cyclosporin A by continuous intravenous infusion at 4mg/kg/day for 20 days. Before and 20 days after cyclosporin A therapy, clinical disease activity was assessed using clinical activity index scores. Colonoscopy and endoscopic ultrasonography were undertaken before and 20 days after cyclosporin A therapy. RESULTS: Following treatment with cyclosporin A, nine patients showed a decrease in clinical activity index score by six points or more and were defined as responders, while the other six were defined as non-responders. Endoscopic ultrasonography measurement using an ultrasonic catheter probe showed that thickness of the rectal mucosal layer before cyclosporin A was significantly greater in responders than in non-responders (p
Original languageEnglish
Pages (from-to)735-739
Number of pages5
JournalDigestive and Liver Disease
Volume41
Issue number10
Early online date28 Apr 2009
DOIs
Publication statusPublished - Oct 2009

Fingerprint

Endosonography
Ulcerative Colitis
Cyclosporine
Steroids
Ultrasonics
Therapeutics
Catheters
Therapeutic Uses
Colonoscopy
Rectum
Intravenous Infusions
Adrenal Cortex Hormones
Colon

Keywords

  • adult
  • colitis, ulcerative
  • colon
  • colonoscopy
  • cyclosporine
  • endosonography
  • female
  • glucocorticoids
  • humans
  • immunosuppressive agents
  • intestinal mucosa
  • male
  • middle aged
  • predictive value of tests
  • prognosis
  • prospective studies
  • young adult

Cite this

Role of endoscopic ultrasonography in predicting the response to cyclosporin A in ulcerative colitis refractory to steroids. / Watanabe, O; Ando, T; El-Omar, E M; Shimada, M; Ina, K; Ishiguro, K; Hasegawa, M; Miyake, N; Nakamura, M; Miyahara, R; Ohmiya, N; Niwa, Y; Goto, H.

In: Digestive and Liver Disease, Vol. 41, No. 10, 10.2009, p. 735-739.

Research output: Contribution to journalArticle

Watanabe, O, Ando, T, El-Omar, EM, Shimada, M, Ina, K, Ishiguro, K, Hasegawa, M, Miyake, N, Nakamura, M, Miyahara, R, Ohmiya, N, Niwa, Y & Goto, H 2009, 'Role of endoscopic ultrasonography in predicting the response to cyclosporin A in ulcerative colitis refractory to steroids', Digestive and Liver Disease, vol. 41, no. 10, pp. 735-739. https://doi.org/10.1016/j.dld.2009.03.014
Watanabe, O ; Ando, T ; El-Omar, E M ; Shimada, M ; Ina, K ; Ishiguro, K ; Hasegawa, M ; Miyake, N ; Nakamura, M ; Miyahara, R ; Ohmiya, N ; Niwa, Y ; Goto, H. / Role of endoscopic ultrasonography in predicting the response to cyclosporin A in ulcerative colitis refractory to steroids. In: Digestive and Liver Disease. 2009 ; Vol. 41, No. 10. pp. 735-739.
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AU - Ina, K

AU - Ishiguro, K

AU - Hasegawa, M

AU - Miyake, N

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AU - Ohmiya, N

AU - Niwa, Y

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N2 - BACKGROUND AND AIMS: Although cyclosporin A has been reported to be effective in the treatment of severe ulcerative colitis, factors predicting its therapeutic efficacy remain unclear. Technical progress in endoscopic ultrasonography has improved visualisation of the structure of the colon wall. Here, to assess the value of endoscopic ultrasonography in predicting the response to cyclosporin A treatment, we evaluated the therapeutic effect of cyclosporin A by determining the pre- and post-cyclosporin A thickness of the mucosal layer in the rectum using endoscopic ultrasonography with an ultrasonic catheter probe. PATIENTS AND METHODS: Fifteen ulcerative colitis patients who did not respond to high-doses of corticosteroids were treated with cyclosporin A by continuous intravenous infusion at 4mg/kg/day for 20 days. Before and 20 days after cyclosporin A therapy, clinical disease activity was assessed using clinical activity index scores. Colonoscopy and endoscopic ultrasonography were undertaken before and 20 days after cyclosporin A therapy. RESULTS: Following treatment with cyclosporin A, nine patients showed a decrease in clinical activity index score by six points or more and were defined as responders, while the other six were defined as non-responders. Endoscopic ultrasonography measurement using an ultrasonic catheter probe showed that thickness of the rectal mucosal layer before cyclosporin A was significantly greater in responders than in non-responders (p

AB - BACKGROUND AND AIMS: Although cyclosporin A has been reported to be effective in the treatment of severe ulcerative colitis, factors predicting its therapeutic efficacy remain unclear. Technical progress in endoscopic ultrasonography has improved visualisation of the structure of the colon wall. Here, to assess the value of endoscopic ultrasonography in predicting the response to cyclosporin A treatment, we evaluated the therapeutic effect of cyclosporin A by determining the pre- and post-cyclosporin A thickness of the mucosal layer in the rectum using endoscopic ultrasonography with an ultrasonic catheter probe. PATIENTS AND METHODS: Fifteen ulcerative colitis patients who did not respond to high-doses of corticosteroids were treated with cyclosporin A by continuous intravenous infusion at 4mg/kg/day for 20 days. Before and 20 days after cyclosporin A therapy, clinical disease activity was assessed using clinical activity index scores. Colonoscopy and endoscopic ultrasonography were undertaken before and 20 days after cyclosporin A therapy. RESULTS: Following treatment with cyclosporin A, nine patients showed a decrease in clinical activity index score by six points or more and were defined as responders, while the other six were defined as non-responders. Endoscopic ultrasonography measurement using an ultrasonic catheter probe showed that thickness of the rectal mucosal layer before cyclosporin A was significantly greater in responders than in non-responders (p

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