Cyclosporin in the treatment of adults with refractory coeliac disease--an open pilot study

Aliment Pharmacol Ther. 2000 Jun;14(6):767-74. doi: 10.1046/j.1365-2036.2000.00718.x.


Aim: To evaluate the effect of cyclosporin treatment on clinical and histological parameters in adult patients with refractory coeliac disease.

Methods: Thirteen patients were treated with oral cyclosporin for 2 months, aiming at serum levels of 100-200 ng/mL. Seven extended medication intake up to a maximum of 12 months. Before and after treatment, clinical parameters were monitored and small intestinal biopsies taken. Ten of 13 patients were typed for HLA-DQA1 and -DQB1 alleles.

Results: Eight of 13 patients responded histologically to cyclosporin treatment. Normalization of villi was demonstrated in five patients, three after prolonged treatment. Eight patients reported a clinical response, of whom six had concomitant histological improvement. No serious side-effects of cyclosporin were noticed. Nine of 10 patients who were immunogenetically typed carried the coeliac disease associated serologic DQ2 markers, one carried neither DQ2 nor DQ8 markers.

Conclusion: In our study group of 13 adult refractory coeliac disease patients, cyclosporin in therapeutic doses induced a histological improvement in eight patients (61%), in five of whom (38%) normalization of villi was demonstrated. Thus, we believe that cyclosporin is a therapeutic option in refractory coeliac disease, although we could not confirm earlier reports of unconditional successful treatment.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Celiac Disease / drug therapy*
  • Celiac Disease / pathology
  • Cyclosporine / pharmacology
  • Cyclosporine / therapeutic use*
  • Female
  • Humans
  • Immunosuppressive Agents / pharmacology
  • Immunosuppressive Agents / therapeutic use*
  • Intestinal Mucosa / drug effects
  • Intestinal Mucosa / ultrastructure
  • Intestine, Small / drug effects
  • Intestine, Small / pathology
  • Male
  • Middle Aged
  • Pilot Projects
  • Recurrence
  • Treatment Outcome


  • Immunosuppressive Agents
  • Cyclosporine