Background:
Cyclosporine is considered a safe and effective treatment of severe steroid-refractory ulcerative colitis (uc). however, few data are available concerning its safety profile in pregnant women. we report here the experience of 5 getaid centers.
Methods:
In a retrospective study data on patients with severe uc treated with cyclosporine during pregnancy were extracted from medical records of consecutive patients treated between 2001 and 2007.
Results:
Eight patients (median age 30.5 years old) were identified. at the time of flare-up the median duration of pregnancy was 11.5 weeks of gestation (range 4-25). seven patients had pancolitis. all patients had more than 3 commonly used clinical and biological severity criteria. three patients had severe endoscopic lesions and 5 patients had not. all patients received intravenous corticosteroids for at least 7 days before introduction of cyclosporine. two patients received azathioprine during treatment with cyclosporine. no severe infections or other complications due to treatment were observed. treatment was effective in 7/8 patients. one patient received infliximab due to cyclosporine therapy failure with a good outcome. no colectomy was performed during pregnancy. seven pregnancies were conducted to term, but 1 in utero death occurred due to maternal absence of s-protein. two newborns were premature, including 1 case of hypotrophy. no malformations were observed.
Conclusions:
In our experience, treatment with cyclosporine for steroid-refractory uc during pregnancy can be considered safe and effective.