TRANSDERMAL NICOTINE FOR ACTIVE ULCERATIVE-COLITIS
TRANSDERMAL NICOTINE FOR ACTIVE ULCERATIVE-COLITIS
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DOI：
10.1056/nejm199403243301202
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发表时间：
1994-03-24
影响因子：
158.5
通讯作者：
SAWE, U
中科院分区：
文献类型：
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作者：
PULLAN, RD;RHODES, J;SAWE, U
背景溃疡性结肠炎主要是一种非吸烟者的疾病。由于轶事报道表明，吸烟和尼古丁可能会改善疾病的症状，我们研究了尼古丁作为溃疡性结肠炎的补充治疗的效果。在一项随机、双盲研究中，我们用尼古丁透皮贴剂或安慰剂贴剂治疗72例活动性溃疡性结肠炎患者6周。给予递增剂量的尼古丁;大多数患者耐受剂量为每24小时15至25 mg。所有患者均服用美沙拉嗪，12名患者接受低剂量糖皮质激素;这些药物在研究期间继续使用。在基线和研究结束时进行临床、乙状结肠镜检查和组织学评估;每天在日记卡上记录症状，临床医生进行总体评估。在整个研究过程中监测副作用和血浆尼古丁和可替宁浓度。尼古丁组35例患者中有17例完全缓解，而安慰剂组37例患者中有9例完全缓解（P = 0.03）。尼古丁组患者结肠炎的总体临床分级改善更明显（P
Background. Ulcerative colitis is largely a disease of nonsmokers. Because anecdotal reports suggest that smoking and nicotine may improve the symptoms of the disease, we examined the effect of nicotine as a supplemental treatment for ulcerative colitis.Methods. We treated 72 patients with active ulcerative colitis with either transdermal nicotine patches or placebo patches for six weeks in a randomized, double-blind study. Incremental doses of nicotine were given; most patients tolerated doses of 15 to 25 mg per 24 hours. All the patients had been taking mesalamine, and 12 were receiving low doses of glucocorticoids; these medications were continued without change during the study. Clinical, sigmoidoscopic, and histologic assessments were made at base line and at the end of the study; symptoms were recorded daily on a diary card, and the clinician made a global assessment. Side effects and plasma nicotine and cotinine concentrations were monitored throughout the study.Results. Seventeen of the 35 patients in the nicotine group had complete remissions, as compared with 9 of the 37 patients in the placebo group (P = 0.03). The patients in the nicotine group had greater improvement in the global clinical grade of colitis (P