Efficacy and tolerability of mesalazine foam enema (Salofalk foam) for distal ulcerative colitis: a double‐blind, randomized, placebo‐controlled study

• Published in: Alimentary pharmacology & therapeutics Vol. 14; no. 9; pp. 1191 - 1198
• Main Authors: POKROTNIEKS, J, MARLICZ, K, PARADOWSKI, L, MARGUS, B, ZABOROWSKI, P, GREINWALD, R
• Format: Journal Article
• Language: English
• Published: Oxford UK Blackwell Science Ltd 01.09.2000; Blackwell
• Subjects: Adult; Aged; Anti-Inflammatory Agents, Non-Steroidal - administration & dosage; Anti-Inflammatory Agents, Non-Steroidal - adverse effects; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use; Biological and medical sciences; Colitis, Ulcerative - classification; Colitis, Ulcerative - drug therapy; Digestive system; Double-Blind Method; Drug Delivery Systems; Enema; Female; Humans; Male; Medical sciences; Mesalamine - administration & dosage; Mesalamine - adverse effects; Mesalamine - therapeutic use; Middle Aged; Patient Acceptance of Health Care; Pharmacology. Drug treatments; Severity of Illness Index; Treatment Outcome; Human; Rectal form; Inflammatory disease; Enema; Non steroidal antiinflammatory agent; Chemotherapy; Treatment; Foam; Mesalazine; Dosage form; Digestive diseases; Intestinal disease; Salicylates; Ulcerative colitis
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1046/j.1365-2036.2000.00784.x

Background: Rectal formulations of mesalazine are the treatment of choice in mildly to moderately active ulcerative colitis. A new foam formulation of mesalazine was developed to improve both drug delivery and patient acceptance. Methods: In this multicentre, randomized, double‐blind, parallel‐group study, 111 patients with mildly to moderately active proctitis, proctosigmoiditis, or left‐sided ulcerative colitis received mesalazine foam enema or placebo enema (2 g mesalazine per day) for 6 weeks. Disease activity was monitored on the basis of the Clinical Activity Index, Endoscopic Index, Histological Index, and global efficacy assessment by the investigators. Safety assessments included the recording of adverse events, laboratory variables and vital signs. Results: Clinical remission was more frequent in the mesalazine group than the placebo group (65% vs. 40%; P=0.0082), particularly in patients with mild disease and patients with proctosigmoiditis. The frequency of patients with an endoscopic remission was higher in the mesalazine group (57%) than in the placebo group (37%). Similarly, 59% of patients receiving mesalazine but only 41% of those receiving placebo showed an improved Histological Index. The foam enemas were generally well‐tolerated, and no treatment‐related changes on laboratory variables and vital signs were noted. Conclusions: Mesalazine foam enema was well‐tolerated and was more effective than placebo in the treatment of patients with distal ulcerative colitis.