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Cyclosporin therapy heals colon ulcers.

Cyclosporin therapy heals colon ulcers

A pilot study suggests a potent immunosuppressive drug can help people with severe ulcerative colitis, an inflammatory disease of the colon. If further research confirms the finding, the drug may save some colitis patients from surgery to remove part of the large intestine.

Simon Lichtiger and Daniel H. Present of the Mount Sinai Medical Center in New York City report that colitis symptoms improved in six of 11 patients treated with cyclosporin, a drug well known in the field of transplantation for its ability to prevent organ rejection.

"Considering the fact that all of these patients would have lost their colon in surgery, we believe a 55 percent response rate is a significant breakthrough in the treatment of ulcerative colitis," Lichtiger said at this week's Digestive Disease Week meeting in Washington, D.C. The meeting was sponsored by the American Gastroenterological Association and three other medical subspecialty groups.

Researchers suspect ulcerative colitis results from the immune system's misguided attack on a person's own colon cells. Immunosuppressants are prescribed to curb such attacks.

Lichtiger and Present studied hospitalized patients with severe colitis who did not respond to conventional treatments such as steriod drugs. All 11 were surgery candidates but opted for the experimental cyclosporin treatment in a last-ditch attempt to save their colons. The researchers gave these patients intravenous cyclosporin for one to two weeks. Those who responded to the initial dose were sent home and given steriods and oral cyclosporin for six months.

At the end of the six-month period, the researchers found that five of the six patients who had responded to the drug were in complete remission -- they felt better, had stopped taking steriods and cyclosporin and showed no signs of the raw ulcers that had peppered the linings of their colons. The sixth patient had improved but still needed steriod therapy to control colitis symptoms, the researchers report.

Many questions about the experimental therapy remain, including a concern that cyclosporin causes kidney damage. So far, Lichtiger and Present say they haven't seen evidence of such damage, as measured by blood vessels of waste products. But a larger study they are planning in conjunction with researchers at the University of Chicago and the University of California, Los Angeles, should provide a better idea of the drug's efficacy and safety in ulcerative colitis. Researchers expect to begin enrolling patients in that study this August.
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Author:Fackelmann, K.A.
Publication:Science News
Date:May 20, 1989
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