title: Rectal and colonic mesalazine concentration in ulcerative colitis: oral vs. oral plus topical treatment.
abstract: OBJECTIVE
  To measure mucosal concentrations of mesalazine in ulcerative colitis patients treated with oral mesalazine alone, compared to patients treated with both topical and oral mesalazine.
  
  
  METHODS
  Twenty-two patients with mild to moderate ulcerative colitis were randomized to receive 2.4 g/day of oral mesalazine (11 patients) or 2.4 g/day oral plus 4 g/day of topical mesalazine (11 patients). After 2 weeks of treatment, endoscopic biopsies specimens were taken from the rectum and in descending colon just distal of the splenic flexure and stored to -80 degrees C for later assay (HPLC). Wilcoxon's rank sum test for unpaired data was used for the statistical analysis.
  
  
  RESULTS
  Mucosal levels of mesalazine in the rectum were significantly higher in patients who received oral plus topical treatment than in those who had oral treatment alone (52.1 ng/mg, range: 13.6-122.1 vs. 0.2 ng/mg, range: 0.2-9.7, respectively; P < 0.0001). Similarly, in the descending colon, the mucosal concentrations of mesalazine were significantly higher in patients who had oral plus topical treatment than in those receiving oral treatment alone (46.6 ng/mg, range: 6-112.6 vs. 15.9 ng/mg, range: 2.3-42.4, respectively; P=0.01).
  
  
  CONCLUSIONS
  Topical treatment of mesalazine significantly increases mucosal concentrations of mesalazine up to the splenic flexure, supporting the rationale to treat left-sided ulcerative colitis with topical formulations of mesalazine.
authors.affiliation: Gastroenterology Unit, University of l'Aquila, Italy. frieri@mail.crown-net.com
authors.forename: G
authors.initials: G
authors.lastname: Frieri
authors.forename: M T
authors.initials: MT
authors.lastname: Pimpo
authors.forename: G C
authors.initials: GC
authors.lastname: Palumbo
authors.forename: L
authors.initials: L
authors.lastname: Onori
authors.forename: A
authors.initials: A
authors.lastname: Viscido
authors.forename: G
authors.initials: G
authors.lastname: Latella
authors.forename: B
authors.initials: B
authors.lastname: Galletti
authors.forename: G C
authors.initials: GC
authors.lastname: Pantaleoni
authors.forename: R
authors.initials: R
authors.lastname: Caprilli
mesh_terms: D000284:Administration, Oral; D000287:Administration, Topical; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000493:pharmacokinetics*; D003093:Colitis, Ulcerative / Q000378:metabolism*; D003106:Colon / Q000378:metabolism*; D003113:Colonoscopy; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000378:metabolism; D008297:Male; D019804:Mesalamine / Q000008:administration & dosage / Q000493:pharmacokinetics*; D008875:Middle Aged; D012007:Rectum / Q000378:metabolism*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D019804:Mesalamine