Evidence-based On-call

Inflammatory bowel disease

Therapy

For active disease that fails to respond to steroids, consider cyclosporine ^a

Why?

It improves symptoms, but adverse effects are common (particularly paraesthesia, temperature intolerance and hypertension) ^a

Cyclosporine improves symptoms in steroid-resistant disease

Patient	Treatment	Comparison	Outcome	CER	RRR (95% CI)	NNT (95% CI)
active ulcerative colitis ^a	cyclosporine for up to 14 days	placebo	improvement at 7 days	0.0%		1 (1 to 2)
active chronic Crohn's disease ^a	cyclosporine for 3 months	placebo	symptom improvement at 6 months	14%	160% (4% to 540%)	4 (2 to 29)
			adverse effects at 3 months	14%	-270% (-890% to -36%)	-3 (-8 to -2)