Rebamipide enema therapy as a treatment for patients with active distal ulcerative colitis
Rebamipide enema therapy as a treatment for patients with active distal ulcerative colitis
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DOI：
10.1111/j.1440-1746.2006.04399.x
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发表时间：
2007-02-01
影响因子：
4.1
通讯作者：
Goto, Hidemi
中科院分区：
文献类型：
--
作者：
Furuta, Ryuichi;Ando, Takafumi;Goto, Hidemi
背景：糖皮质激素治疗溃疡性结肠炎（UC）的临床疗效已得到公认。然而，长期使用这些药物可能会导致严重的并发症。瑞巴派特{2-（4-氯苯甲酰氨基）-3-[2-（1H）-喹啉酮-4-基]丙酸}是一种细胞保护剂，据报道具有抗炎活性并修复动物结肠炎模型中的粘膜损伤。本研究的目的是评估一种新的瑞巴派特灌肠治疗UC patient.Methods的临床疗效和安全性：20例活动性远端型UC患者中，皮质类固醇治疗不成功的瑞巴派特直肠给药，每天两次，3周，在此期间，皮质类固醇剂量保持不变。根据临床症状和内镜检查结果评价治疗效果。瑞巴派特的抗炎作用也进行了检查，通过监测组织学炎症的强度和细胞因子活性水平的变化在直肠mucosal.Results：在3周后开始瑞巴派特灌肠治疗，11例（55%）达到临床缓解。16例（80%）被结肠镜判定为应答者，在粘膜组织器官培养物中，白细胞介素（IL）-1 β水平降低，但IL-8水平不变，IL-1受体拮抗剂/IL-1 β比值升高。浸润性中性粒细胞数量的变化与对该疗法的临床反应无显著相关性。结论：瑞巴派特灌肠治疗糖皮质激素难治性活动性远端型UC是安全有效的。
Background: The clinical efficacy of corticosteroids in the treatment of ulcerative colitis (UC) is well-established. However, prolonged usage of these drugs can result in serious complications. Rebamipide {2-(4-chlorobenzoylamino)-3[2-(1H)-quinolinon-4-yl] propionic acid}, a cytoprotective agent, has been reported to have anti-inflammatory activity and to repair mucosal injury in animal colitis models. The aim of the present study was to assess the clinical efficacy and safety of a novel Rebamipide enema therapy in UC patients.Methods: Twenty patients with the active distal type of UC in whom corticosteroid treatment had been unsuccessful were treated with rectal administration of Rebamipide twice a day for 3 weeks, during which corticosteroid dosage was kept constant. The efficacy of treatment was assessed from clinical symptoms and endoscopic findings. The anti-inflammatory effect of Rebamipide was also examined by monitoring changes in the intensity of histological inflammation and levels of cytokine activity in the rectal mucosa.Results: At 3 weeks after the initiation of Rebamipide enema therapy, 11 patients (55%) achieved clinical remission. Sixteen (80%) were colonoscopically judged to be responders, with decreased levels of interleukin (IL)-1 beta but not of IL-8, and an increased ratio of IL-1 receptor antagonist/IL-1 beta in organ cultures of mucosal tissues. The change in the number of infiltrating neutrophils was not significantly correlated with the clinical response to this therapy. No side-effects were noted in any patients.Conclusion: Rebamipide enema therapy proved to be safe and useful in corticosteroid-refractory patients with the active distal type of UC.