| Summary: | Fifteen patients with severe active Crohn's disease, refractory to conventional
therapy, were given a 16 week course of cyclosporine ar an initial oral daily
dose of 10 mg/kg, adjusted to maintain cyclosporine scrum trough levels between 100
and 200 ng/ml. Five patients withdrew early because of side effects, poor absorption or
noncompliance. T he remaining 10 patients all improved within four weeks as
measured by three different clinical indices: Crohn's Disease Activity Index, Simple
Index of Crohn's Disease Activity and Mean Score of Therapeutic Goals (MSTG).
Seven patients maintained this initial improvement and prednisone was either
reduced or discontinued. Four of these seven patients relapsed with in four weeks of
stopping cyclosporine, and three remain in remission after 75 ± 2 weeks. Side effects
were minor and easily reversible. When the various clinical and laboratory indices
were compared, MSTG was found to be the most useful index for the assessment of
therapy. Cyclosporine appears to be a safe and effective therapy in patients with severe
active Crohn's disease refractory to conventional therapy.
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