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Cyclosporine and infliximab were shown in a prior randomized controlled trial to be equally effective for patients with acute severe ulcerative colitis refractory to intravenous steroids (NEJM JW Gastroenterol Feb 2013 and Lancet 2012 380:1909). However, infliximab has become increasingly popular because of ease of administration and was favored over cyclosporine in nonrandomized studies.
Investigators in the UK have now conducted a multicenter, randomized, open-label trial to compare the use of cyclosporine versus infliximab in 270 patients with acute severe ulcerative colitis who failed to respond to steroids. The mean interval for intravenous steroids was 5 days in both groups. Patients received infliximab (5 mg/kg at 0, 2, and 6 weeks) o…