Key result
Ridogrel enemas linked to decreased disease scores in ~45% of active left-sided ulcerative colitis patients.
Why the study?
Do Ridogrel enemas improve disease activity and reduce mucosal inflammatory mediators in patients with active left-sided ulcerative colitis?
Do Ridogrel enemas improve disease activity and reduce mucosal inflammatory mediators in patients with active left-sided ulcerative colitis?
In a small pilot study, Ridogrel enemas selectively reduced mucosal TxB2 concentration in patients with active left-sided ulcerative colitis, with variable clinical improvement.
Should not yet change practice in ulcerative colitis; leaves open efficacy of ridogrel in controlled trials.
OBJECTIVE: To evaluate the effect of Ridogrel enemas (Janssen Research Foundation, Beerse, Belgium) on disease activity and mucosal inflammatory mediators in patients with active left-sided ulcerative colitis. DESIGN AND METHODS: Eleven patients with active left-sided ulcerative colitis were evaluated in an open non-placebo-controlled pilot study. All patients were treated with Ridogrel enemas (300 mg/40 ml once daily) over four weeks. A disease activity score based on clinical, endoscopic and histological criteria was obtained before and after treatment with Ridogrel. The concentrations of thromboxane B2 (TxB2), prostaglandin E2 (PGE2), interleukin-6 (IL-6) and tumour necrosis factor alpha (TNF-alpha) were measured in mucosal biopsies before and after treatment. RESULTS: One patient discontinued treatment because of progression of disease, the other ten patients tolerated the Ridogrel enemas well. Mucosal TxB2 concentration decreased significantly in all patients. The mucosal concentrations of the other inflammatory mediators (PGE2, IL-6 and TNF-alpha) were unaltered. The disease score decreased in five patients. However, clinical improvement was not always associated with a decrease in endoscopic and/or histological scores. CONCLUSIONS: This pilot study shows that Ridogrel enemas selectively reduce mucosal TxB2 concentration.
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Auwerda et al. (2001) studied active left-sided ulcerative colitis (n=11). Ridogrel enemas was evaluated on disease activity score and mucosal inflammatory mediators. Ridogrel enemas selectively reduced mucosal TxB2 concentration and decreased the disease score in 5 of 11 patients with active left-sided ulcerative colitis.
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