Role of endoscopic ultrasonography in predicting the response to cyclosporin A in ulcerative colitis refractory to steroids

O. Watanabe, T. Ando, E. M. El-Omar, M. Shimada, K. Ina, K. Ishiguro, M. Hasegawa, N. Miyake, M. Nakamura, R. Miyahara, Naoki Omiya, Y. Niwa, H. Goto

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background and aims: Although cyclosporin A has been reported to be effective in the treatment of severe ulcerative colitis, factors predicting its therapeutic efficacy remain unclear. Technical progress in endoscopic ultrasonography has improved visualisation of the structure of the colon wall. Here, to assess the value of endoscopic ultrasonography in predicting the response to cyclosporin A treatment, we evaluated the therapeutic effect of cyclosporin A by determining the pre- and post-cyclosporin A thickness of the mucosal layer in the rectum using endoscopic ultrasonography with an ultrasonic catheter probe. Patients and methods: Fifteen ulcerative colitis patients who did not respond to high-doses of corticosteroids were treated with cyclosporin A by continuous intravenous infusion at 4 mg/kg/day for 20 days. Before and 20 days after cyclosporin A therapy, clinical disease activity was assessed using clinical activity index scores. Colonoscopy and endoscopic ultrasonography were undertaken before and 20 days after cyclosporin A therapy. Results: Following treatment with cyclosporin A, nine patients showed a decrease in clinical activity index score by six points or more and were defined as responders, while the other six were defined as non-responders. Endoscopic ultrasonography measurement using an ultrasonic catheter probe showed that thickness of the rectal mucosal layer before cyclosporin A was significantly greater in responders than in non-responders (p < 0.05). Further, thickness after cyclosporin A was statistically decreased (p < 0.01) in the responders but not in the non-responders. Conclusions: The ultrasonic catheter probe may represent a useful means of predicting and evaluating the efficacy of cyclosporin A treatment in severely ill ulcerative colitis patients.

Original languageEnglish
Pages (from-to)735-739
Number of pages5
JournalDigestive and Liver Disease
Volume41
Issue number10
DOIs
Publication statusPublished - 01-10-2009
Externally publishedYes

Fingerprint

Endosonography
Ulcerative Colitis
Cyclosporine
Steroids
Ultrasonics
Catheters
Therapeutics
Therapeutic Uses
Colonoscopy
Rectum
Intravenous Infusions
Adrenal Cortex Hormones
Colon

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

Watanabe, O. ; Ando, T. ; El-Omar, E. M. ; Shimada, M. ; Ina, K. ; Ishiguro, K. ; Hasegawa, M. ; Miyake, N. ; Nakamura, M. ; Miyahara, R. ; Omiya, Naoki ; Niwa, Y. ; Goto, H. / Role of endoscopic ultrasonography in predicting the response to cyclosporin A in ulcerative colitis refractory to steroids. In: Digestive and Liver Disease. 2009 ; Vol. 41, No. 10. pp. 735-739.
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abstract = "Background and aims: Although cyclosporin A has been reported to be effective in the treatment of severe ulcerative colitis, factors predicting its therapeutic efficacy remain unclear. Technical progress in endoscopic ultrasonography has improved visualisation of the structure of the colon wall. Here, to assess the value of endoscopic ultrasonography in predicting the response to cyclosporin A treatment, we evaluated the therapeutic effect of cyclosporin A by determining the pre- and post-cyclosporin A thickness of the mucosal layer in the rectum using endoscopic ultrasonography with an ultrasonic catheter probe. Patients and methods: Fifteen ulcerative colitis patients who did not respond to high-doses of corticosteroids were treated with cyclosporin A by continuous intravenous infusion at 4 mg/kg/day for 20 days. Before and 20 days after cyclosporin A therapy, clinical disease activity was assessed using clinical activity index scores. Colonoscopy and endoscopic ultrasonography were undertaken before and 20 days after cyclosporin A therapy. Results: Following treatment with cyclosporin A, nine patients showed a decrease in clinical activity index score by six points or more and were defined as responders, while the other six were defined as non-responders. Endoscopic ultrasonography measurement using an ultrasonic catheter probe showed that thickness of the rectal mucosal layer before cyclosporin A was significantly greater in responders than in non-responders (p < 0.05). Further, thickness after cyclosporin A was statistically decreased (p < 0.01) in the responders but not in the non-responders. Conclusions: The ultrasonic catheter probe may represent a useful means of predicting and evaluating the efficacy of cyclosporin A treatment in severely ill ulcerative colitis patients.",
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Watanabe, O, Ando, T, El-Omar, EM, Shimada, M, Ina, K, Ishiguro, K, Hasegawa, M, Miyake, N, Nakamura, M, Miyahara, R, Omiya, N, Niwa, Y & Goto, H 2009, 'Role of endoscopic ultrasonography in predicting the response to cyclosporin A in ulcerative colitis refractory to steroids', Digestive and Liver Disease, vol. 41, no. 10, pp. 735-739. https://doi.org/10.1016/j.dld.2009.03.014

Role of endoscopic ultrasonography in predicting the response to cyclosporin A in ulcerative colitis refractory to steroids. / Watanabe, O.; Ando, T.; El-Omar, E. M.; Shimada, M.; Ina, K.; Ishiguro, K.; Hasegawa, M.; Miyake, N.; Nakamura, M.; Miyahara, R.; Omiya, Naoki; Niwa, Y.; Goto, H.

In: Digestive and Liver Disease, Vol. 41, No. 10, 01.10.2009, p. 735-739.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Role of endoscopic ultrasonography in predicting the response to cyclosporin A in ulcerative colitis refractory to steroids

AU - Watanabe, O.

AU - Ando, T.

AU - El-Omar, E. M.

AU - Shimada, M.

AU - Ina, K.

AU - Ishiguro, K.

AU - Hasegawa, M.

AU - Miyake, N.

AU - Nakamura, M.

AU - Miyahara, R.

AU - Omiya, Naoki

AU - Niwa, Y.

AU - Goto, H.

PY - 2009/10/1

Y1 - 2009/10/1

N2 - Background and aims: Although cyclosporin A has been reported to be effective in the treatment of severe ulcerative colitis, factors predicting its therapeutic efficacy remain unclear. Technical progress in endoscopic ultrasonography has improved visualisation of the structure of the colon wall. Here, to assess the value of endoscopic ultrasonography in predicting the response to cyclosporin A treatment, we evaluated the therapeutic effect of cyclosporin A by determining the pre- and post-cyclosporin A thickness of the mucosal layer in the rectum using endoscopic ultrasonography with an ultrasonic catheter probe. Patients and methods: Fifteen ulcerative colitis patients who did not respond to high-doses of corticosteroids were treated with cyclosporin A by continuous intravenous infusion at 4 mg/kg/day for 20 days. Before and 20 days after cyclosporin A therapy, clinical disease activity was assessed using clinical activity index scores. Colonoscopy and endoscopic ultrasonography were undertaken before and 20 days after cyclosporin A therapy. Results: Following treatment with cyclosporin A, nine patients showed a decrease in clinical activity index score by six points or more and were defined as responders, while the other six were defined as non-responders. Endoscopic ultrasonography measurement using an ultrasonic catheter probe showed that thickness of the rectal mucosal layer before cyclosporin A was significantly greater in responders than in non-responders (p < 0.05). Further, thickness after cyclosporin A was statistically decreased (p < 0.01) in the responders but not in the non-responders. Conclusions: The ultrasonic catheter probe may represent a useful means of predicting and evaluating the efficacy of cyclosporin A treatment in severely ill ulcerative colitis patients.

AB - Background and aims: Although cyclosporin A has been reported to be effective in the treatment of severe ulcerative colitis, factors predicting its therapeutic efficacy remain unclear. Technical progress in endoscopic ultrasonography has improved visualisation of the structure of the colon wall. Here, to assess the value of endoscopic ultrasonography in predicting the response to cyclosporin A treatment, we evaluated the therapeutic effect of cyclosporin A by determining the pre- and post-cyclosporin A thickness of the mucosal layer in the rectum using endoscopic ultrasonography with an ultrasonic catheter probe. Patients and methods: Fifteen ulcerative colitis patients who did not respond to high-doses of corticosteroids were treated with cyclosporin A by continuous intravenous infusion at 4 mg/kg/day for 20 days. Before and 20 days after cyclosporin A therapy, clinical disease activity was assessed using clinical activity index scores. Colonoscopy and endoscopic ultrasonography were undertaken before and 20 days after cyclosporin A therapy. Results: Following treatment with cyclosporin A, nine patients showed a decrease in clinical activity index score by six points or more and were defined as responders, while the other six were defined as non-responders. Endoscopic ultrasonography measurement using an ultrasonic catheter probe showed that thickness of the rectal mucosal layer before cyclosporin A was significantly greater in responders than in non-responders (p < 0.05). Further, thickness after cyclosporin A was statistically decreased (p < 0.01) in the responders but not in the non-responders. Conclusions: The ultrasonic catheter probe may represent a useful means of predicting and evaluating the efficacy of cyclosporin A treatment in severely ill ulcerative colitis patients.

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