Mesalazine suppositories versus hydrocortisone foam in patients with distal ulcerative colitis. A comparison of the efficacy and practicality of two topical treatment regimens.

Author(s): Farup PG, Hovde O, Halvorsen FA, Raknerud N, Brodin U

Affiliation(s): Dept. of Medicine, Gjovik County Hospital, Norway.

Publication date & source: 1995-02, Scand J Gastroenterol., 30(2):164-70.

Publication type: Clinical Trial; Multicenter Study; Randomized Controlled Trial

BACKGROUND: Topical treatment is effective in patients with distal ulcerative colitis. This trial compares the efficacy, safety, and practicality of 4 weeks' treatment with 500 mg mesalazine suppositories with those of 178 mg hydrocortisone foam, both given twice daily. METHODS: Seventy-nine patients with distal ulcerative colitis were stratified on the basis of the extent of the disease (proctitis and proctosigmoiditis) and randomized to one of the treatment groups. A disease activity index (DAI) based on symptoms and endoscopic findings was calculated. The patients evaluated the practicality of the treatment regimens, patients compliance was measured, and histologic findings recorded. RESULTS: Of all the patients 22% and 38% were complete responders after 2 and 4 weeks, respectively. Median DAIs in the mesalazine and hydrocortisone groups before and after 2 and 4 weeks' treatment were 14, 6, and 4, and 13, 8, and 6, respectively. The difference between the treatment groups was statistically significant (p = 0.02) due to a better effect of mesalazine in patients with proctitis. Patients' evaluation of practicality and patient compliance were statistically significantly better in the mesalazine group. CONCLUSIONS: Both treatment regimens are effective; mesalazine suppositories seem to be the preferred alternative.