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World J Gastroenterol. Feb 28, 2006; 12(8): 1278-1280
Published online Feb 28, 2006. doi: 10.3748/wjg.v12.i8.1278
Pulse cyclophosphamide therapy for inflammatory bowel disease
Zsolt Barta, László Tóth, Margit Zeher
Zsolt Barta, Margit Zeher, 3rd Department of Medicine, Faculty of Medicine, Medical and Health Science Centre, University of Debrecen, Debrecen, Hungary
László Tóth, Department of Pathology, Faculty of Medicine, Medical and Health Science Centre, University of Debrecen, Debrecen, Hungary
Author contributions: All authors contributed equally to the work.
Correspondence to: Zsolt Barta, MD, 3rd Department of Medicine, Faculty of Medicine, Medical and Health Science Centre, University of Debrecen, H-4012 Debrecen, Móricz Zs. krt 22, Hungary. mailto:barta@iiibel.dote.hu
Telephone: +36-52-414969 Fax: +36-52-414969
Received: April 5, 2005
Revised: July 12, 2005
Accepted: July 20, 2005
Published online: February 28, 2006
Abstract

AIM: To assess the efficacy of intravenous cyclophosphamide pulse therapy for refractory inflammatory bowel disease (IBD).

METHODS: We included in our cohort eight patients with (moderate/severe) steroid refractory IBD (4 with ulcerative colitis and 4 with Crohn’s disease). They all received 6 cycles of intravenous cyclophosphamide (800 mg) per month.

RESULTS: Patients entered into remission after the second/third cyclophosphamide pulse. Disease activity decreased. There were no side effects and toxicity. All the patients went into long lasting remission. All Crohn’s disease patients and 3 of 4 ulcerative colitis patients achieved complete remission. One patient with ulcerative colitis showed an impressive clinical response but did not enter into remission. For the maintenance, patients with Crohn’s disease were treated with methotrexate (15 mg/wk) and patients with ulcerative colitis were treated with azathioprine (2.5 mg/kg body weight/d).

CONCLUSION: Remission was maintained in all patients for 6 mo on the average. The drug was well tolerated. These findings suggest that aggressive immunosuppressive therapy may be useful in some refractory patients and further controlled study should be considered in order to fully evaluate this type of treatment as a potential therapy for IBD..

Keywords: Crohn’s disease; Ulcerative colitis; Cyclophosphamide