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Evidence summaries

Cyclosporine for Induction of Remission in Crohn's Disease

Low dose oral cyclosporine may be ineffective for treatment of active Crohn's disease and entails risk of nephrotoxicity. Level of evidence: "C"

A Cochrane review [Abstract] 1 included four studies: one on high dose cyclosporine with 72 patients and three on low dose cyclosporine. The first study found that patients receiving high dose cyclosporine (median 7.6 mg/kg/day) had statistically significant clinical improvement at 12 weeks compared to placebo patients. None of the low dose studies found any statistically significant benefit for clinical improvement or induction of remission for low dose cyclosporine treatment (5 mg/kg/day) used by itself or in combination with corticosteroids compared to placebo. Cyclosporine was associated with a significantly higher proportion of adverse events and withdrawals due to adverse events relative to placebo.

Comment: The quality of evidence is downgraded by study quality (more than 20% loss to follow up) and by imprecise results (limited study size for each comparison).

    References

    • McDonald JW, Feagan BG, Jewell D, Brynskov J, Stange EF, Macdonald JK. Cyclosporine for induction of remission in Crohn's disease. Cochrane Database Syst Rev 2005 Apr 18;(2):CD000297 [Last assessed as up-to-date: 17 June 2008]. [PubMed]

Primary/Secondary Keywords