Role of sulphydryl-containing agents in the management of recurrent attacks of ulcerative colitis. A new approach.
This double-blind randomised study investigated the role of sulphydryl-containing agents in the management of recurrent attacks of ulcerative colitis. To this end, DL-cysteine (200 mg 4 times daily) and DL-methionine-methyl sulphonium chloride (MMSC, 500 mg 4 times daily) were administered orally. Patients with recurrent attacks of moderate proctosigmoidal ulcerative colitis, despite prophylaxis by oral sulphasalazine (2 g daily), were given prednisolone by mouth, 10 mg four times a day, sulphasalazine by mouth, 500 mg four times a day, and morning and evening retention enema (Predsol 20 mg) alone or with cysteine or MMSC. After 2 weeks of treatment with sulphasalazine and prednisolone, 51% of patients (n = 45) were symptom free. Addition of cysteine (n = 46) or MMSC (n = 47) to this regimen controlled the symptoms within 2 weeks in 85% of patients (p < 0.01). During 12 months of prophylactic treatment, 5% of patients (n = 42) receiving sulphasalazine (2 g daily) and cysteine and 5% of patients (n = 41) taking sulphasalazine (2 g daily) and MMSC relapsed, relative to 27% of cases with sulphasalazine (2 g daily) alone (p < 0.01). These results demonstrate that sulphydryl-containing agents play a key role in the treatment of and protection against ulcerative colitis.
University Department of Surgery, Medical City, Baghdad, Iraq.
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Salim
D000328:Adult; D000368:Aged; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D003093:Colitis, Ulcerative / Q000097:blood / Q000188:drug therapy*; D003545:Cysteine / Q000627:therapeutic use; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use; D011446:Prospective Studies; D012008:Recurrence; D012460:Sulfasalazine / Q000627:therapeutic use; D013438:Sulfhydryl Compounds / Q000627:therapeutic use*; D014814:Vitamin U / Q000627:therapeutic use
D000897:Anti-Ulcer Agents; D013438:Sulfhydryl Compounds; D014814:Vitamin U; D012460:Sulfasalazine; D011239:Prednisolone; D003545:Cysteine