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Nicotine enemas for active Crohn's colitis: an open pilot study.
J R Ingram1, J Rhodes, B K Evans
1Department of Gastroenterology, Cardiff and Vale NHS Trust, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, UK.
Gastroenterology Research and Practice
|September 17, 2008
Summary
Nicotine enemas showed clinical benefit for most patients with active Crohn's colitis, reducing disease activity and inflammation markers. This treatment was well-tolerated and safe in this pilot study.
Area of Science:
- Gastroenterology
- Pharmacology
Background:
- Smoking negatively impacts Crohn's disease (CD), but non-nicotine factors may be responsible.
- Transdermal nicotine shows benefits in ulcerative colitis (UC), suggesting potential for CD.
Purpose of the Study:
- To evaluate the efficacy and safety of nicotine enemas for active Crohn's colitis.
Main Methods:
- An open pilot study administered 6 mg nicotine enemas daily for 4 weeks to patients with active rectosigmoid CD.
- Assessed Crohn's Disease Activity Index (CDAI), sigmoidoscopy, and inflammatory markers before and after treatment.
Main Results:
- Mean CDAI decreased from 202 to 153, with improvement in 6/10 patients.
- Bowel movement frequency reduced in 8 patients, and sigmoidoscopy grade improved in 7.
- Mean C-reactive protein levels dropped from 22.0 to 12.3 mg/L; no adverse event withdrawals.
Conclusions:
- Nicotine enemas demonstrated clinical benefit in the majority of patients with active Crohn's colitis.
- The treatment was safe and well-tolerated in this patient cohort.
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