A double blind controlled trial of prednisolone-21-phosphate suppositories in the treatment of idiopathic proctitis

Je, Lennard-Jones; Jh, Baron; Am, Connell; Fa, Jones

doi:10.1136/gut.3.3.207

Cited by 67 publications

(16 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although patients with ulcerative colitis respond to treatment with corticosteroids, only about 25% of patients with proctitis can be expected to go into full remission with topical treatment (Lennard-Jones, Baron, Connell, and Jones, 1962). Those with a long history of symptoms appear less likely to respond to this form of treatment (Truelove, 1959).…”

Section: Discussionmentioning

confidence: 99%

Disodium cromoglycate in the treatment of chronic proctitis.

Heatley¹,

Calcraft²,

Rhodes³

et al. 1975

Gut

103

View full text Add to dashboard Cite

SUMMARY The effect of topical disodium cromoglycate (DSCG) has been examined in 30 patients with chronic active proctitis using a double-blind crossover trial. Each treatment period was four weeks and patients were given DSCG 200 mg by enema twice daily and 100 mg orally three times each day. Twenty-six patients completed the trial successfully, 14 responded to DSCG treatment, two improved with placebo, and 10 responded to neither.Patients who responded to DSCG had significantly more eosinophils in their rectal biopsies than those who failed to respond and in some instances the counts were very high. The findings support the hypothesis that an allergic reaction is important in the pathogenesis of proctitis.Disodium cromoglycate (DSCG) is of proven clinical value in allergic bronchial asthma where it is thought to reduce the degranulation of mast cells in bronchial mucosa (Pepys, Hargreave, Chan, and McCarthy, 1968). Chronic proctitis is an inflammatory condition of unknown aetiology affecting the rectal mucosa. In a related condition, ulcerative proctocolitis, mast cell degranulation is a common feature in rectal biopsies (Bercovitz and Sommers, 1966). It is therefore pertinent to examine whether DSCG, if given topically, would have a beneficial effect in patients with proctitis. Proctitis is a particularly suitable condition to examine because in addition to recording any symptomatic response, the rectal mucosa can be both inspected and biopsied directly. A randomized, double-blind crossover trial was designed to examine the effect of this compound in a group of patients with chronic proctitis. Methods PATIENTSThirty patients with chronic proctitis were included in the trial but four were subsequently withdrawn. All had active symptoms which included rectal bleeding, the passage of mucus, and a change in bowel habit, usually with increased frequency. In all the rectal mucosa was abnormal on sigmoidoscopy. The subsequent details refer to the 26 patients

show abstract

Section: Discussionmentioning

confidence: 99%

Disodium cromoglycate in the treatment of chronic proctitis.

Heatley¹,

Calcraft²,

Rhodes³

et al. 1975

Gut

103

View full text Add to dashboard Cite

show abstract

“…Placebocontrolled trials conducted nearly 50 years ago demonstrated the benefits of rectally administered corticosteroids for UC. 12,13 In a meta-analysis of these and other data, 14 the pooled odds ratios (ORs) for symptomatic and endoscopic improvement were 0.21 (95% CI, 0.07 to 0.71) and 0.27 (95% CI, 0.10 to 0.77). Stated another way, rectally administered corticosteroids were 4 to 5 times more likely to result in symptomatic and endoscopic improvement than placebo.…”

Section: Technical Reviewmentioning

confidence: 95%

“…The treatment of acute UP and L‐UC has historically involved rectally administered corticosteroids. Placebo‐controlled trials conducted nearly 50 years ago demonstrated the benefits of rectally administered corticosteroids for UC 12,13. In a meta‐analysis of these and other data,14 the pooled odds ratios (ORs) for symptomatic and endoscopic improvement were 0.21 (95% CI, 0.07 to 0.71) and 0.27 (95% CI, 0.10 to 0.77).…”

Section: Technical Reviewmentioning

confidence: 99%

Medical management of left-sided ulcerative colitis and ulcerative proctitis: Critical evaluation of therapeutic trials

Regueiro

Loftus

Steinhart

et al. 2006

Inflammatory Bowel Diseases

108

View full text Add to dashboard Cite

show abstract

“…formulations applied per rectum) have long been recognized as an important therapeutic approach in patients with ulcerative colitis, as either first-line therapy in patients with disease limited to the distal colon or rectum, or as combination therapy in patients with more extensive colitis [470,471]. A recent metaanalysis described pooled odds ratios for symptomatic and endoscopic improvement at 0.21 (95% CI 0.07-0.71) and 0.27 (95% CI, 0.10-0.77), respectively [472].…”

Section: Topical Corticosteroidsmentioning

confidence: 99%

Inflammatory Bowel Disease

Stenson

Hanauer

Cohen

2008

Textbook of Gastroenterology

View full text Add to dashboard Cite

In the US, H. pylori vacA shows allelic variation in the signal sequence (which may be type sla, slb or s2) and the mid-region (type ml or m2). Previous PCR-based vacA mid-region typing classified most, but not all, Asian and South American strains tested as ml or m2. We now sought to investigate vacA mid-region diversity further.MotlmodL We studied 13 Japanese, 6 Chinese, 9 Thai, and 8 Peruvian H. pylori isolates. cagA was identified by colony hybridisation (CH), vacA signal sequence was typed by PCR, and vacA mid-region was typed proximally by CH and distally by PCR. Sections of the vacA mid-region from 8 strains were PCR-amplified, sequenced, and compared with known sequences from 8 other strains.Rcuts Of the 36 Asian and South American strains studied, 35 were cagA+ (the cagA-was Peruvian) and 35 were vacA sla (1 cagA + Peruvian was slb). vacA mid-regions from the 13 Japanese strains were not PCR-amplified by ml or m2-specific primers, but hybridised weakly with an ml probe. Sequence analysis of vacA from 1 Japanese strain revealed 91% nucleotide identity with the ml probe but only 71% identity with the m2 probe. The previously equivocal Thai and Peruvian strains also had ml-like mid-region sequences. A Chinese strain was ml in the proximal mid-region and m2 distally, showing a clear crossover site. Final mid-region types were: Japanese, all 13 ml; Chinese, 1 ml, 1 ml/m2, 4 m2; Thai, 3 ml, 6 m2; Peruvian 4 ml, 4 m2. Distal mid-region sequences of 16 strains, compared over 294 bp, clustered into 2 groups, ml and m2. Nucleotide identity between ml and m2 strains ranged from 73-78%. Within groups, m2 strains were less diverse than ml strains (m2 range 94-99.7%, ml 88-99.3%, p<0.001). Sequence analysis of 7 ml and 3 m2 strains over 1.1kb proximally showed maintenance of clustering outside the 294bp region C duions These Asian and South American strains are similar in terms of cagA status and vacA sla genotype, but fall into 2 vacA midregion groups. ml sequences are more diverse than m2, and thus may be phylogenetically older. The vacA sequence of 1 Chinese strain suggests recombination in vivo between ml and m2 alleles. Introduction: H.pylori antimicrobial susceptibility is an important determinant ofthe efficacy of eradication therapies'. The prevalence of antimicrobial resistance varies within the UK and may increase given the increased use of eradication therapy. This multicentre study assesses the prevalence and possible associations ofH.pylon antimicrobial resistance. Methods: H.pylon was isolated from antral biopsies of patients undergoing routine endoscopy and cultured according to standard microbiological methods. Antimicrobial resistance was determined using "E-tests" or disc tests (tinidazole only) with breakpoints defined by previous studies. Results: H.pyloni was isolated from 32% (1222/3823) of patients and antimicrobial susceptibility determined in 90% (1077/1222) Previous case-control studies of IBD have used hospital or community derived controls. There are obvious inherent biases in both metho...

show abstract

A double blind controlled trial of prednisolone-21-phosphate suppositories in the treatment of idiopathic proctitis

Cited by 67 publications

References 2 publications

Disodium cromoglycate in the treatment of chronic proctitis.

Disodium cromoglycate in the treatment of chronic proctitis.

Medical management of left-sided ulcerative colitis and ulcerative proctitis: Critical evaluation of therapeutic trials

Inflammatory Bowel Disease

Contact Info

Product

Resources

About