Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2024 Jun 14;11(6):e01368.
doi: 10.14309/crj.0000000000001368. eCollection 2024 Jun.

Sirolimus Use in Refractory Crohn's Disease

Rex K Siu  1 , Christian Karime  1 , Jana G Hashash  2 , Jami Kinnucan  2 , Michael F Picco  2 , Francis A Farraye  2
Affiliations
Case Reports

Sirolimus Use in Refractory Crohn's Disease

Rex K Siu et al. ACG Case Rep J. .

Abstract

Treatment options for patients with inflammatory bowel disease are constantly evolving; however, medication-refractory disease remains an issue. Pediatric case series show the potential benefit of sirolimus therapy in refractory Crohn's disease (CD); however, limited data exist in adult patients. As such, we retrospectively identified and report clinical outcomes for 4 patients prescribed sirolimus for treatment of refractory CD. Despite a median sirolimus therapy duration of 524 days and some therapeutic benefits, all patients discontinued therapy due to adverse effects. Our findings suggest that while sirolimus may have clinical utility, its role may be limited by treatment-derived adverse effects.

Keywords: Crohn's disease; adverse effects; extremity edema; immunomodulator; inflammatory bowel disease; poor wound healing; sirolimus.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Patient selection. We retrospectively identified adult patients with IBD utilizing International Classification Diseases-10 codes (K51.* and K52.*) who were prescribed systemic sirolimus for primary indication of IBD treatment. Patients with a history of bone marrow or organ transplantation and sole use of topical sirolimus were excluded. Sixteen patients with a diagnosis of IBD who had been prescribed sirolimus were identified. Subsequent manual verification and exclusion for bone marrow or organ transplant reduced the cohort to a sample of 4 patients, all of which have Crohn's disease. CD, Crohn's disease; IBD, inflammatory bowel disease; UC, ulcerative colitis.
See this image and copyright information in PMC

References

    1. Tsui JJ, Huynh HQ. Is top-down therapy a more effective alternative to conventional step-up therapy for Crohn’s disease? Ann Gastroenterol. 2018;31(4):413–24. - PMC - PubMed
    1. Gomollón F, Dignass A, Annese V, et al. . 3rd European evidence-based consensus on the diagnosis and management of Crohn's disease 2016: Part 1: Diagnosis and medical management. J Crohns Colitis. 2017;11(1):3–25. - PubMed
    1. Sehgal SN. Sirolimus: Its discovery, biological properties, and mechanism of action. Transplant Proc. 2003;35(3 Suppl l):S7–S14. - PubMed
    1. Mutalib M, Borrelli O, Blackstock S, et al. . The use of sirolimus (rapamycin) in the management of refractory inflammatory bowel disease in children. J Crohns Colitis. 2014;8(12):1730–4. - PubMed
    1. Herrera-deGuise C, Serra-Ruiz X, Lastiri E, Borruel N. JAK inhibitors: A new dawn for oral therapies in inflammatory bowel diseases. Front Med (Lausanne). 2023;10:1089099. - PMC - PubMed

Publication types