Cyclosporine in Inflammatory Bowel Disease

Efficacy and Safety in Ulcerative Colitis

In acute severe ulcerative colitis refractory to IV steroids, cyclosporine at 2 mg/kg/day IV is an established rescue therapy with 76-85% short-term response rates, according to the European Crohn’s and Colitis Organisation 1

Infliximab has proven efficacy in both active and fistulating Crohn's disease through multiple controlled trials and should be the primary consideration for severe refractory disease, as recommended by the American Gastroenterological Association 2
Anti-TNF therapy addresses both luminal inflammation and perianal complications with established long-term efficacy, with a strength of evidence rated as high by the National Institute for Health and Care Excellence 3
Azathioprine (2.0-3.0 mg/kg/day) or 6-mercaptopurine (1.5 mg/kg/day) are effective for maintenance therapy in Crohn's disease, though onset of action is slower, according to the Crohn's and Colitis Foundation of America 3
Methotrexate at 25 mg/week (parenteral) is an alternative immunomodulator with a 51% three-year remission rate, as reported by the European Crohn’s and Colitis Organisation 2