Tacrolimus: a new immunosuppressant for steroid refractory inflammatory bowel disease

Novel Therapies for Crohn's Disease: Focus on Immunomodulators and Antibiotics

“…One of these reported the effects of tacrolimus in 30 prednisonerefractory patients with inflammatory bowel disease. 29 In the group of 6 Crohn's disease patients and 2 indeterminate colitis patients, 6 improved and 4 achieved remission (CDAI <150). Discontinuation of treatment resulted in relapse for 4 of the patients with Crohn's disease.…”

“…19 In this dose-escalating study, investigators administered rhu-IL-10 daily subcutaneously for 28 days. The primary efficacy endpoint was complete remission (CDAI score <150 points at day 29), and a decrease in CDAI score of greater than 100 points plus an improvement in endoscopic appearance of the colon. The secondary efficacy endpoint was quality of life assessed using the IBDQ.…”

Rescue Therapy with Tacrolimus for a Patient with Severe Ulcerative Colitis Refractory to Combination Leukocytapheresis and High-Dose Corticosteroid Therapy

“…Tacrolimus, however, is well-absorbed orally, compared to intravenous administration, even in severe colitis (4,13). Moreover, recent evidence from transplant patients suggests that tacrolimus is superior to CyA with respect to immunosuppressive potency and has a lower incidence of side effects (14,15).…”

“…Tacrolimus has immunosuppressive properties similar to CyA, but is approximately 100 times more potent than CyA (16) (3,4,18,19 (19,20).…”

Inducing remission in inflammatory bowel disease

“…Some of these are traditionally used for other indications, and some are not currently licensed in the UK. Data suggesting clinical improvement with tacrolimus21 and thalidomide22 come from uncontrolled trials, while evidence of effectiveness with heparin,23 interleukin 10,24 mycophenolate mofetil25 and natalizumab26 comes from randomised controlled trials.…”