Distal ulcerative colitis refractory to rectal mesalamine: Role of transdermal nicotine versus oral mesalamine

Mario Guslandi, Roberto Frego, Edi Viale, Pier Alberto Testoni

Research output: Contribution to journalArticle

Abstract

Background: Distal ulcerative colitis usually responds to treatment with rectal mesalamine, but the management of refractory cases is poorly defined. Aim: To evaluate the possible therapeutic benefit of transdermal nicotine versus oral mesalamine. Patients and Methods: Thirty patients with left-sided ulcerative colitis unresponsive to treatment with a mesalamine 4 g enema at bedtime were randomly allocated to additional therapy with either transdermal nicotine 15 mg daily or oral mesalamine 800 mg tid for four weeks. Clinical remission was evaluated by Rachmilewitz's activity index and confirmed by sigmoidoscopy. Results: Remission was observed in 12 of 15 patients receiving additional treatment with nicotine and in five of 15 patients receiving additional treatment with oral mesalamine (P=0.027). Conclusions: The addition of transdermal nicotine to treatment with mesalamine enemas is significantly superior to combined therapy with oral and rectal mesalamine in patients with distal ulcerative colitis refractory to rectal mesalamine alone.

Original languageEnglish
Pages (from-to)293-296
Number of pages4
JournalCanadian Journal of Gastroenterology
Volume16
Issue number5
Publication statusPublished - 2002

Keywords

  • Mesalamine
  • Nicotine
  • Ulcerative colitis

ASJC Scopus subject areas

  • Gastroenterology

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