Digestive Diseases and Sciences

, Volume 50, Supplement 1, pp S119–S123 | Cite as

Rebamipide Enemas–New Effective Treatment for Patients with Corticosteroid Dependent or Resistant Ulcerative Colitis

  • Mitsuki Miyata
  • Kunio Kasugai
  • Tetsuya Ishikawa
  • Shinichi Kakumu
  • Masafumi Onishi
  • Takeshi Mori
Article

Abstract

In this study we investigated the effect of rebamipide enema in patients with steroid-resistant and/or dependent ulcerative colitis. Rebamipide enemas were administered twice daily for a 12-week period; this treatment was further continued longer in patients who requested this. Disease activity index as reflecting the clinical condition and endoscopic index with histological grading were determined before and after the treatment period. Nine of 11 (81.8%) patients on 12-week treatment with rebamipide approved and were classified as colitis in remission. Moreover, seven of 11 patients requested long-term medication, the longest medication term being 80 weeks. These results medicated that rebamipide enemas may be effective in patients with steroid-resistant and/or dependent ulcerative colitis.

Key Words

ulcerative colitis rebamipide enema steroid-resistance steroid-dependency long-term administration 

References

  1. 1.
    Schroeder KW, Tremaine WJ, Ilstrup DM: Coated oral 5-aminosalicylic acid therapy for mildly to moderately active ulcerative colitis. A randomized study. N Engl J Med 317:1625–1629, 1987Google Scholar
  2. 2.
    Sninsky CA, Cort DH, Shanaban F, Powers BJ, Sessions JT, Pruitt RE, Jacobs WH, Lo SK, Targan SR, Cerda JJ: Oral mesalamine (Asacol) for mildly to moderately active ulcerative colitis. A Multicenter study [see comments]. Ann Intern Med 115:350–355, 1991Google Scholar
  3. 3.
    Hanauer S, Schwartz J, Robinson M, Roufail W, Arora S, Cello J, Safdi M: Mesalamine capsules for treatment of active ulcerative colitis: results of a controlled trial. Pentasa Study Group. Am J Gastroenterol 88:1188–1197Google Scholar
  4. 4.
    Miner P, Hanauer S, Robinson M, Schwartz J, Arora S: Safety and efficacy of controlled-release mesalamine for maintenance of remission in ulcerative colitis. Pentasa UC Maintenance Study Group. Dig Dis Sci 40:296–304, 1995CrossRefPubMedGoogle Scholar
  5. 5.
    Hawkey CJ, Dube LM, Rountree LV, Linnen PJ, Lancaster JF: A trial of zileuton versus mesalamine or placebo in the maintenance of remission of ulcerative colitis. The European Zileuton Study Group for Ulcerative Colitis. Gastroenterology 112:718–724, 1997CrossRefPubMedGoogle Scholar
  6. 6.
    Hanauer S, Sninsky C, Robinson M, Powers B, McHattie J, Mayle J: An oral preparation of mesalamine as long-term maintenance therapy for ulcerative colitis. A randomized, placebo-controlled trial. Ann Intern Med 124:204–211, 1996PubMedGoogle Scholar
  7. 7.
    Ardizzone S, Petrillo M, Imbesi V, Cerutti R, Bollani S, Bianchi Porro G: Is maintenance therapy always necessary for patients with ulcerative colitis in remission? Aliment Pharmacol Ther 13:373–379, 1999CrossRefPubMedGoogle Scholar
  8. 8.
    Faubion WA Jr, Loftus EV, Harmsen WS, Zinsmeister AR, Sandborn WJ: The natural history of corticosteroid therapy for inflammatory bowel disease: a population-based study. Gastroenterology 121:255–260, 2001CrossRefPubMedGoogle Scholar
  9. 9.
    Makiyama K, Takeshima F, Kawasaki H: Anti-inflammatory effect of rebamipide enema on proctitis type ulcerative colitis: a novel therapeutic alternative. Am J Gastroenterol 95:1838–1839, 2000CrossRefPubMedGoogle Scholar
  10. 10.
    Aihara M, Imagawa K, Funakoshi Y, Ohmoto Y, Kikuchi M: Effect of rebamipide on production of several cytokines by human peripheral blood mononuclear cells. Dig Dis Sci 43:160S–166S, 1998PubMedGoogle Scholar
  11. 11.
    Naito Y, Yoshikawa T, Tanigawa T, Sakurai K, Yamasaki K, Uchida M, Kondo M: Hydroxyl radical scavenging by rebamipide and related compounds: electron paramagnetic resonance study. Free Radical Biol Med 18:117–123, 1995CrossRefGoogle Scholar
  12. 12.
    Yoshikawa T, Naito Y, Tanigawa T, Kondo M: Free radical scavenging activity of the novel anti-ulcer agent rebamipide by electron spin resonance. Arzneim-Forsch/Drug Res 43:363–366, 1993Google Scholar
  13. 13.
    Kishimoto S, Haruma K, Tari A, Sakurai K, Nakano M, Nakagawa Y: Rebamipide, an antiulcer drug, prevents DSS-induced colitis formation in rats. Dig Dis Sci 45:1608–1616, 2000CrossRefPubMedGoogle Scholar
  14. 14.
    Farup PG, Hinterleitner TA, Lukas M, Hebuterne X, Rachmilewitz D, Campieri M, Meier R, Keller R, Rathbone B, Oddsson E: Mesalamine 4 g daily given as prolonged-release granules twice daily and four times daily is at least as effective as prolonged-release tablets four times daily in patients with ulcerative colitis. Inflamm Bowel Dis 7:237–242, 2001CrossRefPubMedGoogle Scholar
  15. 15.
    Rachmilewitz D on behalf of an international study group: Coated mesalazine (5-aminosalicylic acid) versus sulphasalazine in the treatment of active ulcerative colitis. Br Med J 298:82–86, 1989Google Scholar
  16. 16.
    Floren CH, Benoni C, Willen R: Histologic and colonoscopic assessment of disease extension in ulcerative colitis. Scand J Gastroenterol 22:459–462, 1987PubMedGoogle Scholar
  17. 17.
    Sood A, Midha V, Sood N, Avasthi G: Azathioprine versus sulfasalazine in maintenance of remission in severe ulcerative colitis. Indian J Gastroenterol 22:79–81, 2003PubMedGoogle Scholar
  18. 18.
    Sawada K, Ohnishi K, Kosaka T, Chikano S, Yokota Y, Egashira A, Izawa H, Yamamura M, Amano K, Satomi M, Shimoyama T: Leukocytapheresis with leukocyte removal filter as new therapy for ulcerative colitis. Ther Apher 1:207–211, 1997PubMedGoogle Scholar
  19. 19.
    Rayner CK, McCormack G, Emmanuel AV, Kamm MA: Long-term results of low-dose intravenous cyclosporine for acute severe ulcerative colitis. Aliment Pharmacol Ther 18:303–308, 2003CrossRefPubMedGoogle Scholar
  20. 20.
    Armuzzi A, De Pascalis B, Lupascu A, Fedeli P, Leo D, Mentella MC, Vincenti F, Melina D, Gasbarrini G, Pola P, Gasbarrini A. Infliximab in the treatment of steroid-dependent ulcerative colitis. Eur Rev Med Pharmacol Sci. 8:231–233, 2004Google Scholar
  21. 21.
    Sinha A, Nightingale J, West KP, Berlanga-Acosta J, Playford R: Epidermal growth factor enemas with oral mesalamine for mild-to-moderate left-sided ulcerative colitis. N Engl J Med 349:350–357, 2003CrossRefPubMedGoogle Scholar
  22. 22.
    Tarnawski A, Arakawa T, Kobayashi K: Rebamipide treatment activates epidermal growth factor and its receptor expression in normal and ulcerated gastric mucosa in rats: one mechanism for its ulcer healing action? Dig Dis Sci 43:90S–98S, 1998CrossRefPubMedGoogle Scholar
  23. 23.
    Matysiak-Budnik T, de Mascarel A, Abely M, Mayo K, Heyman M, Megraud F: Positive effect of rebamipide on gastric permeability in mice after eradication of Helicobacter fells. Scand J Gastroenterol 35:470–475, 2000CrossRefPubMedGoogle Scholar
  24. 24.
    Matysiak-Budnik T, Thomas-Collignon A, Megraud F, Heyman M: Alteration of epithelial permeability by Helicobacter and IL-1β in vitro: protective effect of rebamipide. Dig Dis Sci 46:1558–1566, 2001CrossRefPubMedGoogle Scholar
  25. 25.
    Tarnawski A, Chai J, Pai R, Chiou SK: Rebamipide activates genes encoding angiogenic growth factors and Cox2 and stimulates angiogenesis: a key to its ulcer healing action? Dig Dis Sci 49:202–209, 2004CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science + Business Media, Inc. 2005

Authors and Affiliations

  • Mitsuki Miyata
    • 1
  • Kunio Kasugai
    • 1
  • Tetsuya Ishikawa
    • 1
  • Shinichi Kakumu
    • 1
  • Masafumi Onishi
    • 1
  • Takeshi Mori
    • 1
  1. 1.Department of GastroenterologyAichi Medical University School of MedicineAichiJapan

Personalised recommendations