Long-term use of mesalamine (Rowasa) suppositories in remission maintenance of ulcerative proctitis

Hanauer, Stephen B; GOOD, L; Goodman, Michael; PIZINGER, R; Strum, Williamson B.; LYSS, C; Haber, Gladys V.; Williams, Carl N.; Robinson, Malcolm

doi:10.1016/s0002-9270(00)00977-1

Cited by 21 publications

(25 citation statements)

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“…Trials of duration less than or equal to 4 weeks [11,12,20,30,51,58,67,111,112] were associated with lower response rate (11.3%) than trials of duration greater than 4 weeks (23.8%) [28,40,45,46,74,78,92]. In the multivariate analysis also the placebo endoscopic remission rate was significantly influenced by duration of trial (P = 0.0013).…”

Section: Endoscopic Remissionmentioning

confidence: 85%

Meta-Analysis of the Placebo Response in Ulcerative Colitis

et al. 2007

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Section: Endoscopic Remissionmentioning

confidence: 85%

Meta-Analysis of the Placebo Response in Ulcerative Colitis

et al. 2007

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“…Mesalamine suppositories have been the mainstay of treatment in these patients [669], with efficacy and safety data superior to corticosteroid preparations [392]. Suppository dosing is typically nightly (twice or three times a day in more refractory patients) (Table 57.6).…”

Section: Ulcerative Proctitismentioning

confidence: 99%

Inflammatory Bowel Disease

Stenson

Hanauer

Cohen

2008

Textbook of Gastroenterology

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In the US, H. pylori vacA shows allelic variation in the signal sequence (which may be type sla, slb or s2) and the mid-region (type ml or m2). Previous PCR-based vacA mid-region typing classified most, but not all, Asian and South American strains tested as ml or m2. We now sought to investigate vacA mid-region diversity further.MotlmodL We studied 13 Japanese, 6 Chinese, 9 Thai, and 8 Peruvian H. pylori isolates. cagA was identified by colony hybridisation (CH), vacA signal sequence was typed by PCR, and vacA mid-region was typed proximally by CH and distally by PCR. Sections of the vacA mid-region from 8 strains were PCR-amplified, sequenced, and compared with known sequences from 8 other strains.Rcuts Of the 36 Asian and South American strains studied, 35 were cagA+ (the cagA-was Peruvian) and 35 were vacA sla (1 cagA + Peruvian was slb). vacA mid-regions from the 13 Japanese strains were not PCR-amplified by ml or m2-specific primers, but hybridised weakly with an ml probe. Sequence analysis of vacA from 1 Japanese strain revealed 91% nucleotide identity with the ml probe but only 71% identity with the m2 probe. The previously equivocal Thai and Peruvian strains also had ml-like mid-region sequences. A Chinese strain was ml in the proximal mid-region and m2 distally, showing a clear crossover site. Final mid-region types were: Japanese, all 13 ml; Chinese, 1 ml, 1 ml/m2, 4 m2; Thai, 3 ml, 6 m2; Peruvian 4 ml, 4 m2. Distal mid-region sequences of 16 strains, compared over 294 bp, clustered into 2 groups, ml and m2. Nucleotide identity between ml and m2 strains ranged from 73-78%. Within groups, m2 strains were less diverse than ml strains (m2 range 94-99.7%, ml 88-99.3%, p<0.001). Sequence analysis of 7 ml and 3 m2 strains over 1.1kb proximally showed maintenance of clustering outside the 294bp region C duions These Asian and South American strains are similar in terms of cagA status and vacA sla genotype, but fall into 2 vacA midregion groups. ml sequences are more diverse than m2, and thus may be phylogenetically older. The vacA sequence of 1 Chinese strain suggests recombination in vivo between ml and m2 alleles. Introduction: H.pylori antimicrobial susceptibility is an important determinant ofthe efficacy of eradication therapies'. The prevalence of antimicrobial resistance varies within the UK and may increase given the increased use of eradication therapy. This multicentre study assesses the prevalence and possible associations ofH.pylon antimicrobial resistance. Methods: H.pylon was isolated from antral biopsies of patients undergoing routine endoscopy and cultured according to standard microbiological methods. Antimicrobial resistance was determined using "E-tests" or disc tests (tinidazole only) with breakpoints defined by previous studies. Results: H.pyloni was isolated from 32% (1222/3823) of patients and antimicrobial susceptibility determined in 90% (1077/1222) Previous case-control studies of IBD have used hospital or community derived controls. There are obvious inherent biases in both metho...

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“…However, accumulating data support the effectiveness of rectally administered treatments for the maintenance of remission in UP. In a placebo-controlled trial [40] , a significantly higher rate of remission maintenance was found in patients treated with mesalazine suppository (500 mg b.i.d.). Subsequent studies demonstrated the superiority of rectally administered treatment in maintenance of remission, even when used intermittently [41,42] .…”

Section: Maintenance Therapymentioning

confidence: 96%

Ulcerative proctitis: a review of pharmacotherapy and management

Lakatos

2008

Expert Opinion on Pharmacotherapy

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Topical medication with rectally administered 5-aminosalicylic acid (5-ASA)/corticosteroid suppositories or enemas is effective treatment for most UP patients. Locally administered 5-ASA is more efficacious than oral compounds. The combination of topical 5-ASA and oral 5-ASA or topical steroids should be considered for escalation of treatment. Maintenance treatment is indicated in all UC cases. 5-ASA suppositories are suggested as first-line maintenance therapy if accepted by patients, although oral 5-ASA as maintenance therapy might prevent proximal extension of the disease. After re-assessment, chronically active patients refractory or intolerant to 5-ASAs and corticosteroids may require immunomodulators or biological therapy. Exceptional cases may require a proctocolectomy.

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Long-term use of mesalamine (Rowasa) suppositories in remission maintenance of ulcerative proctitis

Abstract: The results demonstrate that mesalamine suppositories are efficacious, well tolerated, and safe for the long-term maintenance of remission of ulcerative proctitis.

Cited by 21 publications

References 0 publications

Meta-Analysis of the Placebo Response in Ulcerative Colitis

Meta-Analysis of the Placebo Response in Ulcerative Colitis

Inflammatory Bowel Disease

Ulcerative proctitis: a review of pharmacotherapy and management

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