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AIM:To assess the efficacy of intravenous cyclophos-phamide pulse therapy for refractory inflammatory boweldisease(IBD).METHODS:We included in our cohort eight patientswith(moderate/severe)steroid refractory IBD(4 withulcerative colitis and 4 with Crohn’s disease).They allreceived 6 cycles of intravenous cyclophosphamide(800mg)per month.RESULTS:Patients entered into remission after the sec-ond/third cyclophosphamide pulse.Disease activity de-creased.There were no side effects and toxicity.All thepatients went into long lasting remission.All Crohn’s diseasepatients and 3 of 4 ulcerative colitis patients achievedcomplete remission.One patient with ulcerative colitisshowed an impressive clinical response but did not enterinto remission.For the maintenance,patients with Crohn’sdisease were treated with methotrexate(15 mg/wk)andpatients with ulcerative colitis were treated with azathio-prine(2.5 mg/kg body weight/d).CONCLUSION:Remission was maintained in all pa-tients for 6 mo on the average.The drug was well toler-ated.These findings suggest that aggressive immuno-suppressive therapy may be useful in some refractorypatients and further controlled study should be consid-ered in order to fully evaluate this type of treatment as apotential therapy for IBD.
AIM: To assess the efficacy of intravenous cyclophos-phamide 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). allreceived 6 cycles of intravenous cyclophosphamide (800 mg) per month .RESULTS: Patients entered into remission after the sec-ond / third cyclophosphamide pulse. Disease activity de- creased. There were no side effects and toxicity. All thepatients went into long lasting remission. All Crohn’s disease patients and 3 of 4 ulcerative colitis patients achieved complete remission. One patient with ulcerative colitisshowed an impressive clinical response but not not enterinto remission. For the maintenance, patients with Crohn’s disease were treated with methotrexate (15 mg / wk) and patients with ulcerative colitis were treated with azathio-prine (2.5 mg / kg body weight / d) .CONCLUSION: Remission was maintained in all pa-tients for 6 months on the averag e.The drug was well toler-ated. These findings suggest that aggressive immuno-suppressive therapy may be useful in some refractorypatients and further controlled study should be consid-ered in order to fully evaluate this type of treatment as apotential therapy for IBD.