In patients with acute steroid-refractory UC, does IV cyclosporine reduce the long-term risk of CRC compared with infliximab

What is known

- Direct head-to-head comparisons, including a randomized controlled trial and meta-analyses, found no significant difference between the two agents in colectomy rates or adverse events. ^1–3 - The comparative literature reports colectomy rates, adverse events, and short/long-term treatment outcomes, not cancer incidence. ^1–4

What is unknown / caveats

- No retrieved study addresses whether intravenous cyclosporine reduces long-term colorectal cancer risk versus infliximab. - None of the head-to-head comparisons measured colorectal cancer as an endpoint.

## References

1. Szemes K, Soós A, Hegyi P, Farkas N, Erős A, Erőss B, Mezősi E, Szakács Z, Márta K, Sarlós P. Comparable Long-Term Outcomes of Cyclosporine and Infliximab in Patients With Steroid-Refractory Acute Severe Ulcerative Colitis: A Meta-Analysis. Front Med (Lausanne). 2019;6:338. PMID: 32039218.

2. Eun CS, Han DS. Does the Cyclosporine Still Have a Potential Role in the Treatment of Acute Severe Steroid-Refractory Ulcerative Colitis?. Gut Liver. 2015. PMID: 26343066.

3. Syal G, Robbins L, Kashani A, Bonthala N, Feldman E, Fleshner P, Vasiliauskas E, McGovern D, Ha C, Targan S, Melmed GY. Hypoalbuminemia and Bandemia Predict Failure of Infliximab Rescue Therapy in Acute Severe Ulcerative Colitis. Dig Dis Sci. 2021;66:199-205. PMID: 32170473.

4. Narula N, Marshall JK, Colombel JF, Leontiadis GI, Williams JG, Muqtadir Z, Reinisch W. Systematic Review and Meta-Analysis: Infliximab or Cyclosporine as Rescue Therapy in Patients With Severe Ulcerative Colitis Refractory to Steroids. Am J Gastroenterol. 2016;111:477-91. PMID: 26856754.

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_Draft, generated by the IBDology RAG and not yet clinician-reviewed. Answers are grounded in the retrieved literature listed above; a high faithfulness score means the answer matches its sources, not that the sources are correct._