Topical treatment of inflammatory bowel diseases

Česká verze

Authors: T. Douda
Authors place of work: II. interní gastroenterologická klinika, LF UK a FN Hradec Králové
Published in the journal: Gastroent Hepatol 2015; 69(1): 38-42
Category: IBD: přehledová práce
doi: https://doi.org/10.14735/amgh201538

Summary

The optimal medical treatment of IBD is tailored according to the patient’s needs. Topical treatment of IBD means the direct application of effective medication to the affected area of the colon by rectal administration. Some systemically (per oral) treatment can also cause topically, but it is not our issue.Rectally administered topical agents have a proven efficacy in the treatment of distal colitis and proctitis. The side effects associated with treatment are not commonly seen. In spite of this, topical treatment is seldom used. Topical mesalazine suppositories are effective against proctitis and enemas for left sided ulcerative colitis. The clinical results associated with topical mesalazine suppositories are better than oral 5- ASA’s and are preferred to topical steroids with better clinical, endoscopic as well as histological results. Resisitant distal colitis is very difficult to treat and requires a combination of drugs: per oral mesalazine, systemic steroids or immunosuppressants and anti TNFα alfa blockers that do not always yield satisfactory treatment results. It is describe other less used topical treatment. The effects of these drugs needs futher investigations and double blind prospective trials. The article also concerns the topical treatment of Crohn’s disease, pouchitis and cuffitis.

Key words:
IBD – topical treatment

The author declares he has no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

Submitted:
30. 12. 2014

Accepted:
29. 1. 2015

Zdroje

1. Seibold F, Fournier N, Beglinger C et al. Topical therapy is underused in patients with ulcerative colitis. J Crohns Colitis 2014; 8(1): 56– 63. doi: 10.1016/ j.crohns.2013.03.005.

2. Liptay S, Bachem M, Häcker G et al. Inhibition of nuclear factor kappa B and induction of apoptosis in T‑lymphocytes by sulfasalazine. Br J Pharmacol 1999; 128(7): 1361– 1369.

3. Kaiser GC, Yan F, Polk DB. Mesalamine blocks tumor necrosis factor growth inhibition and nuclear factor kappaB activation in mouse colonocytes. Gastroenterology 1999; 116(3): 602– 609.

4. Dignass A, Lindsay JO, Sturm A et al. Second European evidence‑based consensus on the diagnosis and management of ulcerative colitis part 2: current management. J Crohns Colitis 2012; 6(10): 991– 1030. doi: 10.1016/ j.crohns.2012.09.002.

5. Kruis W, Kiudelis G, Rácz I et al. Once daily versus three times daily mesalazine granules in active ulcerative colitis: a double‑blind, double‑dummy, randomised, non‑inferiority trial. Gut 2009; 58(2): 233– 240. doi: 10.1136/ gut.2008.154302.

6. Flourié B, Hagège H, Tucat G et al. Randomised clinical trial: once‑ vs. twice‑ daily prolonged‑ release mesalazine for active ulcerative colitis. Aliment Pharmacol Ther 2013; 37(8): 767– 775. doi: 10.1111/ apt.12266.

7. Prokopová L, Ďuricová D, Bortlík M et al.Doporučené postupy pro podávání aminosalicylátů u nemocných s idiopatickými střevními záněty. Gastroent Hepatol 2012; 66(5): 391– 400.

8. Eliakim R, Tulassay Z, Kupcinskas L et al. Clinical trial: randomized‑ controlled clinical study comparing the efficacy and safety of a low‑ volume vs. a high‑volume mesalazine foam in active distal ulcerative colitis. Aliment Pharmacol Ther 2007; 26(9): 1237– 1249.

9. Probert CS, Dignass AU, Lindgren S et al.Combined oral and rectal mesalazine for the treatment of mild‑ to‑ moderately active ulcerative colitis: rapid symptom resolution and improvements in quality of life. J Crohns Colitis 2014; 8(3): 200– 207. doi: 10.1016/ j.crohns.2013.08.007.

10. Marshall JK, Thabane M, Steinhart AH et al. Rectal 5– aminosalicylic acid for maintenance of remission in ulcerative colitis. Cochrane Database Syst Rev 2012; 11. doi: 10.1002/ 14651858.CD004118.pub2.

11. Lindgren S, Löfberg R, Bergholm L et al.Effect of budesonide enema on remission and relapse rate in distal ulcerative colitis and proctitis. Scand J Gastroenterol 2002; 37(6): 705– 710.

12. Fiorino G, Gilardi D, Naccarato P et al. Safety and efficacy of sodium hyaluronate (IBD98E) in the induction of clinical and endoscopic remission in subjects with distal ulcerative colitis. Dig Liver Dis 2014; 46(4): 330– 334. doi: 10.1016/ j.dld.2013.12.008.

13. Lawrance IC, Copeland TS. Rectal tacrolimus in the treatment of resistant ulcerative proctitis. Aliment Pharmacol Ther 2008; 28(10): 1214– 1220. doi: 10.1111/ j.1365‑ 2036.2008.03841.x.

14. Van Dieren JM, van Bodegraven AA, Kuipers EJ et al. Local application of tacrolimus in distal colitis: feasible and safe. Inflamm Bowel Dis 2009; 15(2): 193– 198. doi: 10.1002/ ibd.20644.

15. Ranzi T, Campanini MC, Velio P et al. Treatment of chronic proctosigmoiditis with cyclosporin enemas. Lancet 1989; 2(8654): 97.

16. Sandborn WJ, Tremaine WJ, Schroeder KW et al. Cyclosporine enemas for treatment‑resistant, mildly to moderately active, left‑ sided ulcerative colitis. Am J Gastroenterol 1993; 88(5): 640– 645.

17. Winter TA, Dalton HR, Merrett MN et al. Cyclosporin A retention enemas in refractory distal ulcerative colitis and „pouchitis“. Scand J Gastroenterol 1993; 28(8): 701– 704.

18. Sandborn WJ, Tremaine WJ, Schroeder KW et al. A placebo‑ controlled trial of cyclosporine enemas for mildly to moderately active left‑ sided ulcerative colitis. Gastroenterology 1994; 106(6): 1429– 1435.

19. Breuer RI, Soergel KH, Lashner BA et al. Short chain fatty acid rectal irrigation for left‑ sided ulcerative colitis: a randomised, placebo controlled trial. Gut 1997; 40(4): 485– 491.

20. Kono T, Nomura M, Kasai S et al. Effect of ecabet sodium enema on mildly to moderately active ulcerative proctosigmoiditis: an open‑ label study. Am J Gastroenterol 2001; 96(3): 793– 797.

21. Monteleone G, Caprioli F. Drug evaluation: TA‑ 2711E in the treatment of active distal ulcerative colitis. Curr Opin Investig Drugs 2007; 8(5): 423– 428.

22. Sinha A, Nightingale J, West KP et al. Epidermal growth factor enemas with oral mesalamine for mild‑ to‑ moderate left‑ sided ulcerative colitis or proctitis. N Engl J Med 2003; 349(4): 350– 357.

23. Ingram JR, Thomas GA, Rhodes J et al. A randomized trial of nicotine enemas for active ulcerative colitis. Clin Gastroenterol Hepatol 2005; 3(11): 1107– 1114.

24. Forbes A, Britton TC, House IM et al. Safety and efficacy of acetarsol suppositories in unresponsive proctitis. Aliment Pharmacol Ther 1989; 3(6): 553– 556.

25. Auwerda JJ, Zijlstra FJ, Tak CJ et al. Ridogrel enemas in distal ulcerative colitis. Eur J Gastroenterol Hepatol 2001; 13(4): 397– 400.

26. Lawrance IC. Topical agents for idiopathic distal colitis and proctitis. J Gastroenterol Hepatol 2011; 26(1): 36– 43. doi: 10.1111/ j.1440‑ 1746.2010.06497.x.

27. Furuta R, Ando T, Watanabe O et al. Rebamipide enema therapy as a treatment for patients with active distal ulcerative colitis. J Gastroenterol Hepatol 2007; 22(2): 261– 267.

28. Pullan RD, Ganesh S, Mani V et al. Comparison of bismuth citrate and 5- aminosalicylic acid enemas in distal ulcerative colitis: a controlled trial. Gut 1993; 34(5): 676– 679.

29. Sambuelli A, Boerr L, Negreira S et al. Budesonide enema in pouchitis – a double‑blind, double‑dummy, controlled trial. Aliment Pharmacol Ther 2002; 16(1): 27– 34.

30. Miner P, Wedel M, Bane B et al. An enema formulation of alicaforsen, an antisense inhibitor of intercellular adhesion molecule‑ 1, in the treatment of chronic, unremitting pouchitis. Aliment Pharmacol Ther 2004; 19(3): 281– 286.

31. Van Assche G, Dignass A, Bokemeyer Bet al. Second European evidence‑based consensus on the diagnosis and management of ulcerative colitis part 3: special situations. J Crohns Colitis 2013; 7(1): 1– 33. doi: 10.1016/ j.crohns.2012.09.005.

32. Hart AL, Plamondon S, Kamm MA. Topical tacrolimus in the treatment of perianal Crohn‘s disease: exploratory randomized controlled trial. Inflamm Bowel Dis 2007; 13(3): 245– 253.

33. Maeda Y, Ng SC, Durdey P et al. Randomized clinical trial of metronidazole ointment versus placebo in perianal Crohn‘s disease. Br J Surg 2010; 97(9): 1340– 1347. doi: 10.1002/ bjs.7121.