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P396 Cyclosporin A efficacy in a paediatric ulcerative colitis: a retrospective single-centre study

M. Osiecki*, M. Dadalski, J. Kierkus

The Children’s Memorial Health Institute, Gastroenterology, Hepatology, Feeding Disorders and Paediatrics, Warsaw, Poland

Background

According to ECCO/ESPGHAN consensus for managing acute severe ulcerative colitis in children, cyclosporin A remains a rescue therapy in acute steroid-refractory ulcerative colitis. Our aim was to assess a therapeutic efficacy of CsA in such an indication.

Methods

It is a retrospective, single-centre study. We describe a clinical characteristic of 59 children (33F and 26M), mean age of 13.7 years and mean disease duration 32 months, who underwent CsA treatment in the course of UC in years 2005–2015. The primary endpoint was established as clinical remission (defined as PUCAI < 10) or clinical response (defined as decrease in PUCAI scoring for at least 20 points) at day 8. The secondary endpoints were clinical remission/response at month 6 and colectomy rate. The clinical outcome was related to clinical (PUCAI score), laboratory (CsA concentration), endoscopic (disease extension and severity), demographic (age, age of onset, and disease duration) data, and previous anti-TNFalpha exposure.

Results

Short-term response/remission at day 8 was achieved in 43 out of 59 (81%) and 31 out of 59 (58%) patients, respectively. Long-term remission evaluated 6 months after therapy had been sustained in 19 out of 31 patients (63%). The colectomy rate was 25% (15/59). We observed no significant difference between groups with response/remission vs no response remission at both analysed time points in analysed clinical, laboratory, endoscopic, and demographic data. Previous anti-TNFalpha exposure did not affect clinical outcome.

Conclusion

CsA rescue therapy is effective in up to 80% of paediatric UC patients. The 6-months remission was sustained in 32% patient. The colectomy rate was about 25%.