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5-ASA enemas for refractory distal ulcerative colitis. An open trial
1Division of Gastroenterology, St. Michael's Hospital, Toronto, Ontario, Canada.
Journal of Clinical Gastroenterology
|October 1, 1987
Summary
This study investigated 5-aminosalicylic acid (5-ASA) enemas for refractory ulcerative colitis. While some patients showed improvement, 5-ASA enemas were only beneficial for a minority, particularly those not dependent on oral steroids.
Area of Science:
- Gastroenterology
- Clinical Pharmacology
Background:
- Idiopathic distal ulcerative colitis (UC) poses treatment challenges, especially in cases resistant to conventional therapies.
- Systemic corticosteroids are often used for remission but can have significant side effects.
Purpose of the Study:
- To evaluate the efficacy of 5-aminosalicylic acid (5-ASA) enemas in patients with refractory distal ulcerative colitis.
- To determine the role of 5-ASA enemas in patients dependent on oral corticosteroids for disease management.
Main Methods:
- An open-label trial involving 51 patients with refractory distal UC.
- Patients received 4 g of 5-ASA enemas once nightly for two weeks.
- Clinical and sigmoidoscopic assessments were used to evaluate treatment response.
Main Results:
- Overall, 57% of patients (29/51) showed an excellent response, and 21% (11/51) had a satisfactory response.
- 21% of patients (11/51) experienced a poor outcome.
- Two patients reported adverse reactions. Nine of the 11 patients with poor outcomes remained dependent on oral prednisone.
Conclusions:
- 5-ASA enemas may offer benefit to a subset of patients with refractory distal ulcerative colitis.
- The efficacy appears limited, especially in patients requiring systemic corticosteroids for disease remission.
- Further research is needed to define the precise role of 5-ASA enemas in managing steroid-dependent ulcerative colitis.