Rebamipide enema therapy as a treatment for patients with active distal ulcerative colitis

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Journal of Gastroenterology and Hepatology

Volume 22 Issue 2 Page 261 - February 2007

To cite this article: Ryuichi Furuta, Takafumi Ando, Osamu Watanabe, Osamu Maeda, Kazuhiro Ishiguro, Kenji Ina, Kazuo Kusugami, Hidemi Goto (2007) Rebamipide enema therapy as a treatment for patients with active distal ulcerative colitis Journal of Gastroenterology and Hepatology 22 (2), 261–267. doi:10.1111/j.1440-1746.2006.04399.x

GASTROENTEROLOGY

Rebamipide enema therapy as a treatment for patients with active distal ulcerative colitis

Ryuichi Furuta,**Department of Gastroenterology, Nagoya University Graduate School of Medicine,

Takafumi Ando,**Department of Gastroenterology, Nagoya University Graduate School of Medicine, Dr Takafumi Ando, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan. Email: takafumia-gi@...

Osamu Watanabe,**Department of Gastroenterology, Nagoya University Graduate School of Medicine,

Osamu Maeda,**Department of Gastroenterology, Nagoya University Graduate School of Medicine,

Kazuhiro Ishiguro,**Department of Gastroenterology, Nagoya University Graduate School of Medicine,

Kenji Ina,Division of Medical Oncology, Nagoya Memorial Hospital and

Kazuo KusugamiDepartment of Food Science and Nutrition, Nagoya Women's University, Nagoya, Japan and Hidemi Goto**Department of Gastroenterology, Nagoya University Graduate School of Medicine,

*Department of Gastroenterology, Nagoya University Graduate School of Medicine, Division of Medical Oncology, Nagoya Memorial Hospital and Department of Food Science and Nutrition, Nagoya Women's University, Nagoya, Japan

Dr Takafumi Ando, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan. Email: takafumia-gi@...

Abstract

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)-1β but not of IL-8, and an increased ratio of IL-1 receptor antagonist/IL-1β 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.