Format

Send to

Choose Destination
J Crohns Colitis. 2014 Jan;8(1):64-9. doi: 10.1016/j.crohns.2013.03.006. Epub 2013 Apr 9.

Oral tacrolimus for pediatric steroid-resistant ulcerative colitis.

Author information

1
Pediatric Gastroentrology and Nutrition Unit, Hospital Materno Infantil, Málaga, Spain. Electronic address: victor.navas@gmail.com.
2
Pediatric Gastroentrology and Nutrition Unit, Hospital Materno Infantil, Málaga, Spain. Electronic address: javierblascoalonso@yahoo.es.
3
Pediatric Gastroentrology and Nutrition Unit, Hospital Materno Infantil, Málaga, Spain. Electronic address: serranonieto@hotmail.com.
4
Pediatric Gastroentrology and Nutrition Unit, Hospital Materno Infantil, Málaga, Spain. Electronic address: currogiron@gmail.com.
5
Pediatric Gastroentrology and Nutrition Unit, Hospital Materno Infantil, Málaga, Spain. Electronic address: mdargos@gmail.com.
6
Pediatric Gastroentrology and Nutrition Unit, Hospital Materno Infantil, Málaga, Spain. Electronic address: csierra@wanadoo.es.

Abstract

BACKGROUND:

Ulcerative colitis (UC) occurring during childhood is generally extensive and is associated with severe flares that may require intravenous steroid treatment. In cases of corticosteroid resistance is necessary to introduce a second-line treatment to avoid or delay surgery.

AIMS:

To describe the efficacy and safety of oral tacrolimus for the treatment of severe steroid-resistant UC.

METHODS:

We performed a retrospective study that included all patients under age 18 suffering from severe steroid-resistant UC treated with oral tacrolimus during the period January 1998 to October 2012 and with a follow-up period after treatment of 24 months or more.

RESULTS:

A total of ten patients were included. The age at baseline was 9.4±4.9 years, and the time from diagnosis was 1.3 months (IQR, 1-5.7). Seven of the patients were in their first flare of disease. All of them received an oral dose of 0.12 mg/kg/day of tacrolimus divided in two doses. Trough plasma levels of tacrolimus were maintained between 4 and 13 ng/ml. Response was seen in 5/10 patients at 12 months, colectomy was eventually performed in 60% of patients during the follow-up period.

CONCLUSIONS:

Tacrolimus is useful in inducing remission in patients with severe steroid-resistant UC, preventing or delaying colectomy, and allowing the patient and family to prepare for a probable surgery. Tacrolimus may also be used as a treatment bridge for corticosteroid-dependent patients until the new maintenance therapy takes effect.

KEYWORDS:

Children;; Paediatric; Steroids;; Surgery;; Tacrolimus;; Ulcerative colitis;

PMID:
23582736
DOI:
10.1016/j.crohns.2013.03.006
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Silverchair Information Systems
Loading ...
Support Center