Tacrolimus

Tacrolimus is a potent immunosuppressant agent that inhibits the transcription of IL-2 in T-helper cells, used mainly for the prevention of allograft rejection. Uncontrolled retrospective series suggest its efficacy for treatment of fistulizing CD [47-49]. In the only randomized, double-blind, placebo-controlled trial, Sandborn et al. [50] randomized 48 patients with actively draining Crohn's fistulae to placebo or oral tacrolimus (initial dosage of 0.20 mg/kg/day for 10 weeks). A clinical response (closure of at least 50% of fistulae maintained for at least 4 weeks) occurred in 43% of tacrolimus-treated patients and 8% of placebo (p=0.004). However, there was no difference in the complete closure of fistulae, (10% of tacrolimus vs. 8% placebo). Adverse events observed in patients treated with tacrolimus include renal insufficiency, tremor, headaches, paresthesias, leg cramps and tremor.

In a subsequent study, ten patients with fistulae refractory to medical therapy (including infliximab) and on long-term steroids or immunosuppressors, were treated with oral tacrolimus (0.05 mg/kg every 12 hours) with 6-24 months follow-up. Four achieved a complete response and five achieved a partial response and could discontinue or reduce steroids and immunosuppressors with no serious side effect [51].

Was this article helpful?

0 0
Headache Happiness

Headache Happiness

Headache Happiness! Stop Your Headache BEFORE IT STARTS. How To Get Rid Of Your Headache BEFORE It Starts! The pain can be AGONIZING Headaches can stop you from doing all the things you love. Seeing friends, playing with the kids... even trying to watch your favorite television shows. And just think of how unwelcome headaches are while you're trying to work.

Get My Free Ebook


Post a comment