SOME ASPECTS OF TREATMENT FOR LEFT-SIDED ULCERATIVE COLITIS

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Abstract

Background: There is no published data on changes in the endoscopic activity index within first weeks of treatment with various pharmaceutical forms of mesalazine.
Aim: Comparative assessment of clinical efficacy and safety of various pharmaceutical forms of mesalazine (tablets, enemas and foam) in the treatment of left-sided ulcerative colitis.
Materials and methods: Thirty patients with chronic relapsing left-sided moderate ulcerative colitis participated in the study. They were administered mesalazine either orally (group 1, n = 10) or rectally in micro-enemas (group 2, n = 10) and as foam (group 3, n = 10). Activity of ulcerative colitis was accessed before and after the treatment, along with collecting of patient responses regarding the ease of their use.
Results: The mean index of ulcerative colitis activity among all patients before treatment was 7.2 ± 0.8 points. After 1 week of treatment with oral mesalazine, the index of ulcerative colitis activity decreased to 5.2 points and in those patients who were using microenemas and foam, to 4.6 and 3.4 points, respectively, with the difference before/after treatment being significant only in the group 3 (p < 0.05). At 2 weeks of treatment, the activity index decreased more than 2-fold in all groups (p < 0.05). According to the questionnaire, 83.3% of patients accepted the oral intake of the agent as the most convenient one. The highest proportion of compliant patients was in the group using the foam.
Conclusion: Mesalazine is highly effective, as shown by a 2-fold decrease in the ulcerative colitis activity index after 2 weeks of treatment. The endoscopic activity index shows more rapid decrease after the use of mesalazine foam (already at 1 week of treatment).

About the authors

P. A. Makarchuk

Moscow Regional Research and Clinical Institute

Author for correspondence.
Email: polikpo30@rambler.ru
Makarchuk Pavel Aleksandrovich – PhD, Senior Research Fellow, Department of Gastroenterology and Hepatology Россия

O. M. Tsodikova

Moscow Regional Research and Clinical Institute

Email: polikpo30@rambler.ru
Tsodikova Ol'ga Markovna – Research Fellow, Department of Gastroenterology and Hepatology Россия

Yu. M. Buzunova

Moscow Regional Research and Clinical Institute

Email: polikpo30@rambler.ru
Buzunova Yuliya Mikhaylovna – Junior Research Fellow, Department of Gastroenterology and Hepatology Россия

E. A. Belousova

Moscow Regional Research and Clinical Institute

Email: polikpo30@rambler.ru
Belousova Elena Aleksandrovna – MD, PhD, Professor, Head of Department of Gastroenterology and Hepatology Россия

References

  1. Белоусова ЕА. Язвенный колит и болезнь Крона. М.: Триада; 2002. 127 с.
  2. Адлер Г. Болезнь Крона и язвенный колит. М.: ГЭОТАР-Медиа; 2001. 500 с.
  3. Румянцев ВГ. Язвенный колит: руководство для врачей. М.: МИА; 2009. 424 с.
  4. Головенко ОВ, Михайлова ТЛ, Халиф ИЛ, Головенко АО. Прогноз терапевтического ответа на глюкокортикостероидные препараты у больных с тяжелой формой язвенного колита. Колопроктология. 2010;(3):41–7.
  5. Silverberg MS, Satsangi J, Ahmad T, Arnott ID, Bernstein CN, Brant SR, Caprilli R, Colombel JF, Gasche C, Geboes K, Jewell DP, Karban A, Loftus EV Jr, Peña AS, Riddell RH, Sachar DB, Schreiber S, Steinhart AH, Targan SR, Vermeire S, Warren BF. Toward an integrated clinical, molecular and serological classification of inflammatory bowel disease: report of a Working Party of the 2005 Montreal World Congress of Gastroenterology. Can J Gastroenterol. 2005;19 Suppl A:5A–36A.
  6. D'Haens G, Sandborn WJ, Feagan BG, Geboes K, Hanauer SB, Irvine EJ, Lémann M, Marteau P, Rutgeerts P, Schölmerich J, Sutherland LR. A review of activity indices and efficacy end points for clinical trials of medical therapy in adults with ulcerative colitis. Gastro enterology. 2007;132(2):763–86.
  7. Dignass A, Eliakim R, Magro F, Maaser C, Chowers Y, Geboes K, Mantzaris G, Reinisch W, Colombel JF, Vermeire S, Travis S, Lindsay JO, Van Assche G. Second European evidence-based consensus on the diagnosis and management of ulcerative colitis part 1: definitions and diag nosis. J Crohns Colitis. 2012;6(10):965–90. doi: 10.1016/j.crohns.2012.09.003.
  8. Dignass A, Lindsay JO, Sturm A, Windsor A, Colombel JF, Allez M, D'Haens G, D'Hoore A, Mantzaris G, Novacek G, Oresland T, Reinisch W, Sans M, Stange E, Vermeire S, Travis S, Van Assche G. Second European evidence-based consensus on the diagnosis and management of ulcerative colitis part 2: current management. J Crohns Colitis. 2012;6(10):991–1030. doi: 10.1016/j.crohns.2012.09.002.
  9. Ивашкин ВТ, Шелыгин ЮА, Абдулганиева ДИ, Абдулхаков РА, Алексеева ОП, Ачкасов СИ, Барановский АЮ, Белоусова ЕА, Головенко ОВ, Григорьев ЕГ, Костенко НВ, Лапина ТЛ, Маев ИВ, Москалев АИ, Низов АИ, Николаева НН, Осипенко МФ, Павленко ВВ, Парфенов АИ, Полуэктова ЕА, Румянцев ВГ, Тимербулатов ВМ, Тертычный АС, Ткачев АВ, Трухманов АС, Халиф АЛ, Хубезов ДА, Чашкова ЕЮ, Шифрин ОС, Щукина ОБ. Рекомендации Российской гастроэнтерологической ассоциации и Ассоциации колопроктологов России по диагностике и лечению взрослых больных язвенным колитом. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2015;25(1):48–65.
  10. OCEBM Levels of Evidence Working Group. The Oxford 2011 Levels of Evidence. Available from: http://www.cebm.net/ocebm-lev-
  11. Cortot A, Maetz D, Degoutte E, Delette O, Meunier P, Tan G, Cazals JB, Dewit O, Hebuterne X, Beorchia S, Grunberg B, Leprince E, D'Haens G, Forestier S, Idier I, Lémann M. Mesalamine foam enema versus mesalamine liquid enema in active left-sided ulcerative colitis. Am J Gastroenterol. 2008;103(12):3106–14. doi: 10.1111/j.1572-0241.2008.02152.x.
  12. Eliakim R, Tulassay Z, Kupcinskas L, Adamonis K, Pokrotnieks J, Bar-Meir S, Lavy A, Mueller R, Greinwald R, Chermesh I, Gross V; International Salofalk Foam Study Group. Clinical trial: randomized-controlled clinical study comparing the efficacy and safety of a low-volume vs. a high-volume mesalazine foam in active distal ulcerative colitis. Aliment Pharmacol Ther. 2007;26(9):1237–49.
  13. Regueiro M, Loftus EV Jr, Steinhart AH, Cohen RD. Medical management of left-sided ulcerative colitis and ulcerative proctitis: critical evaluation of therapeutic trials. Inflamm Bowel Dis. 2006;12(10):979–94.
  14. Safdi M, DeMicco M, Sninsky C, Banks P, Wruble L, Deren J, Koval G, Nichols T, Targan S, Fleishman C, Wiita B. A double-blind comparison of oral versus rectal mesalamine versus combination therapy in the treatment of distal ulcerative colitis. Am J Gastroenterol. 1997;92(10):1867–71.
  15. Travis SP, Dinesen L. Remission in trials of ulcerative colitis: what does it mean? Pract Gastroenterol. 2010;30:17–20.
  16. Katsanos KH, Vermeire S, Christodoulou DK, Riis L, Wolters F, Odes S, Freitas J, Hoie O, Beltra mi M, Fornaciari G, Clofent J, Bodini P, Vatn M, Nunes PB, Moum B, Munkholm P, Limonard C, Stockbrugger R, Rutgeerts P, Tsianos EV; EC-IBD Study Group. Dysplasia and cancer in inflammatory bowel disease 10 years after diagnosis: results of a population-based European collaborative follow-up study. Digestion. 2007;75(2–3):113–21.

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Copyright (c) 2015 Makarchuk P.A., Tsodikova O.M., Buzunova Y.M., Belousova E.A.

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