{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T02:05:21Z","timestamp":1755223521316,"version":"3.43.0"},"reference-count":59,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therap Adv Gastroenterol"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Many patients with severe ulcerative colitis (UC) fail to respond to first-line corticosteroids and require second-line rescue therapy with cyclosporin (CsA) to avoid colectomy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Objectives:<\/jats:title>\n            <jats:p>To assess the short- and long-term effectiveness and safety of CsA therapy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Design:<\/jats:title>\n            <jats:p>A single-center, retrospective study was conducted, including patients who received IV CsA therapy for severe, steroid-refractory UC.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Data on therapeutic response and adverse events (AEs) were reported. The Kaplan-Meier method was used to estimate colectomy-free survival rates. The incidence of inflammatory bowel disease flare-ups and the use of advanced therapies after CsA discontinuation were also assessed. Regression analyses were performed to identify predictors for therapeutic response, colectomy, and AEs with CsA.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              A total of 92 UC patients (54.4% male, mean age: 40.0\u2009\u00b1\u200914.0\u2009years) were included with the median follow-up time of 14\u2009years (IQR: 7\u201318). Clinical response was achieved in 88.0%, and clinical remission was observed in 23.9% of patients after the median 6-day (IQR: 7\u20135) IV phase. A total of 40.7% of responders experienced clinical remission, whereas 13.6% had endoscopic remission at the time of CsA withdrawal (median after 5\u2009months of therapy). Patients receiving concomitant immunomodulators were more likely to achieve clinical remission with CsA (\n              <jats:italic>p<\/jats:italic>\n              \u2009=\u20090.002; OR: 6.4). After CsA discontinuation, 23.5% of patients relapsed within 6\u2009months, while 59.3% of patients were started on biologics. The probability of colectomy-free survival was 74.7%, 62.6%, 57.1%, and 45.6% at 1, 3, 5, and 14\u2009years after CsA initiation. AEs were reported in 53.3% of patients, mainly hyperlipidaemia, hypertension, and infections. Hypoalbuminaemia (&lt;35\u2009g\/L) at treatment initiation increased the risk of AEs (\n              <jats:italic>p<\/jats:italic>\n              \u2009=\u20090.03; OR: 0.4), whereas the occurrence of AEs was not associated with concomitant immunomodulator use (\n              <jats:italic>p<\/jats:italic>\n              \u2009=\u20090.9).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion:<\/jats:title>\n            <jats:p>CsA may be a potent therapeutic option to induce remission in steroid-refractory, severely active UC, and its effectiveness may be enhanced by the concomitant use of immunomodulators, without compromising safety.<\/jats:p>\n          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