Oral tacrolimus (FK 506) in Crohn's disease complicated by fistulae of the perineum

Enzo Ierardi, Mariabeatrice Principi, Maria Rendina, Ruggiero Francavilla, Marcello Ingrosso, Antonio Pisani, Annacinzia Amoruso, Carmine Panella, Antonio Francavilla

Research output: Contribution to journalArticle

Abstract

We describe the cases of two patients with Crohn's disease affected by severe perineal fistulae resistant to conventional therapies, successfully treated with FK 506, a new immunomodulatory drug. It is well absorbed from diseased bowel and preliminary experiences have indicated its short-term use in complicated Crohn's disease. The first patient was a 24-year old male with perineal fistula and severe skin ulceration (8 cm of external opening diameter). He had undergone colectomy and ileostomy because of severe pancolitis refractory to medical treatment and had been treated with azathioprine and metronidazole. Two months after starting FK 506, a dramatic improvement made further surgical operation unnecessary. Local and general benefit was observed during the following 26 months, until FK 506 was withdrawn. The second patient was a 28-year-old male with a diagnosis of ulcerative pancolitis changed to Crohn's disease two months after the onset of a perineal fistula, recurring despite drainage procedures, steroid therapy, and total parenteral nutrition. FK 506 was administered for two months with a complete healing of fistula. Successively, it was stopped and corticosteroids (associated to enteral nutrition) were given because of recurrent rectal bleeding. Our experience encourages the use of oral FK 506 in complicated Crohn's disease and suggests the possibility of a long-term primary therapy other than the use as a 'bridge' to other treatments.

Original languageEnglish
Pages (from-to)200-202
Number of pages3
JournalJournal of Clinical Gastroenterology
Volume30
Issue number2
DOIs
Publication statusPublished - Mar 2000

Keywords

  • Chron's disease
  • Fistula
  • Tacrolimus

ASJC Scopus subject areas

  • Gastroenterology

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    Ierardi, E., Principi, M., Rendina, M., Francavilla, R., Ingrosso, M., Pisani, A., Amoruso, A., Panella, C., & Francavilla, A. (2000). Oral tacrolimus (FK 506) in Crohn's disease complicated by fistulae of the perineum. Journal of Clinical Gastroenterology, 30(2), 200-202. https://doi.org/10.1097/00004836-200003000-00015