title: Plasma fibrinogen in ulcerative colitis: the effect of disease activity and nicotine therapy in a randomised controlled trial.
abstract: BACKGROUND
  Smoking increases plasma fibrinogen and cardiovascular risk whereas transdermal nicotine may not. Fibrinogen is an acute phase protein and may reflect disease activity in ulcerative colitis.
  
  
  OBJECTIVE
  To examine the effect of topical nicotine on plasma fibrinogen and any relationship between fibrinogen and ulcerative colitis disease activity.
  
  
  METHODS
  Forty-eight non-smokers with moderately active ulcerative colitis.
  
  
  METHODS
  Patients were randomised to 6 mg nicotine enema or placebo for 6 weeks, followed by open nicotine therapy for 4 weeks. Plasma fibrinogen was measured at baseline and after 6 and 10 weeks; at each assessment sigmoidoscopy with a rectal biopsy was performed. RESULTS.: At 6 weeks median plasma fibrinogen was 3.30 g/l on nicotine compared to 3.05 g/l on placebo, P = 0.90 when adjusted for baseline values. There was a correlation between fibrinogen and the UC disease activity index (UCDAI) at weeks 0 and 10, P = 0.036 and 0.033, respectively, and between fibrinogen and sigmoidoscopic grade at each assessment, P = 0.014, 0.021 and 0.034. Changes in fibrinogen did not correlate with changes in disease severity.
  
  
  CONCLUSIONS
  There was no significant effect of nicotine enemas, in either direction, on plasma fibrinogen-this was raised in moderately active UC and correlated with the sigmoidoscopic grade of colitis and the UCDAI; however, fibrinogen was not sufficiently sensitive to be of practical clinical value.
authors.affiliation: Department of Gastroenterology, University Hospital of Wales, Heath Park, Cardiff and Vale NHS Trust, Cardiff CF14 4XW, UK.
authors.forename: J R
authors.initials: JR
authors.lastname: Ingram
authors.forename: J
authors.initials: J
authors.lastname: Rhodes
authors.forename: P W
authors.initials: PW
authors.lastname: Collins
authors.forename: G T
authors.initials: GT
authors.lastname: Williams
authors.forename: R G
authors.initials: RG
authors.lastname: Newcombe
authors.forename: G A O
authors.initials: GA
authors.lastname: Thomas
mesh_terms: D003093:Colitis, Ulcerative / Q000097:blood*; D004733:Enema; D005260:Female; D005340:Fibrinogen / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000008:administration & dosage / Q000494:pharmacology*; D018722:Nicotinic Agonists / Q000008:administration & dosage / Q000494:pharmacology*; D012680:Sensitivity and Specificity; D012812:Sigmoidoscopy
chemical_list: D018722:Nicotinic Agonists; D009538:Nicotine; D005340:Fibrinogen