Long-term effect of tacrolimus therapy in patients with refractory ulcerative colitis.

Abstract:

BACKGROUND:Little is known about long-term outcome of tacrolimus therapy for ulcerative colitis. Aim To evaluate long-term efficacy and safety of tacrolimus in Japanese patients with refractory ulcerative colitis. METHODS:Twenty-seven patients with UC refractory to conventional therapy were administered tacrolimus with trough whole-blood levels of 10-15 ng/mL to induce remission and 5-10 ng/mL to maintain remission. Median treatment duration was 11 months (1-39 months) and median follow-up duration was 17 months (2-65 months). Evaluation of the clinical response was based on a modified Truelove-Witts severity index (MTWSI). RESULTS:Tacrolimus produced a clinical response in 21 patients (77.8%), and remission was achieved in 19 of these 21 (70.4%) within 30 days. Overall cumulative colectomy-free survival was estimated as 62.3% at 65 months. In 18 of 19 patients treated with corticosteroids at the initiation of tacrolimus therapy, corticosteroids were discontinued or tapered. Adverse events were tremor (25.9%), renal function impairment (18.5%), infectious disease (14.8%), hot flashes (11.1%), hyperkalaemia (7.4%), headache (7.4%), epigastralgia (7.4%) and nausea (3.7%). No mortality occurred. CONCLUSION:Long-term administration of tacrolimus appears to be an effective and well-tolerated treatment for Japanese patients with refractory ulcerative colitis.

journal_name

Aliment Pharmacol Ther

authors

Yamamoto S,Nakase H,Mikami S,Inoue S,Yoshino T,Takeda Y,Kasahara K,Ueno S,Uza N,Kitamura H,Tamaki H,Matsuura M,Inui K,Chiba T

doi

10.1111/j.1365-2036.2008.03764.x

subject

Has Abstract

pub_date

2008-09-01 00:00:00

pages

589-97

issue

5

eissn

0269-2813

issn

1365-2036

pii

APT3764

journal_volume

28

pub_type

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