fluticasone and Colitis--Ulcerative

Topics: Administration, Topical; Androstadienes; Anti-Inflammatory Agents; Beclomethasone; Budesonide; Clinical Trials as Topic; Colitis, Ulcerative; Crohn Disease; Fluticasone; Humans; Hydrocortisone; Prednisolone; Pregnenediones

Fluticasone propionate is a corticosteroid with the potential for topical treatment of ulcerative colitis because of low systemic bioavailability. The drug was compared with prednisolone in the management of active left sided or total ulcerative colitis. Two hundred and five patients were studied in the multicentre four week double blind study. Prednisolone was given in a dose of 40 mg daily orally, reducing over four weeks to 10 or 20 mg. Fluticasone propionate was given in an oral daily dose of 20 mg. The primary end point was the investigator's overall assessment of response. Patient's assessment, sigmoidoscopic appearance, and histology were also studied. Patients improved more rapidly with prednisolone. Differences between the two groups were significant at two weeks. At four weeks differences were not significant, but there was a trend in favour of prednisolone. Corticosteroid side effects were minimal in the fluticasone propionate group, and there was minimal suppression of the hypothalamic pituitary adrenal axis. Fluticasone propionate 20 mg daily is not as effective in the treatment of active ulcerative colitis as prednisolone tapering from 40 mg daily to 10 or 20 mg. The complete absence of suppression of the corticoadrenal axis by fluticasone propionate was encouraging, however, and a higher dosage schedule should be assessed.

Topics: Adolescent; Adult; Aged; Androstadienes; Anti-Inflammatory Agents; Colitis, Ulcerative; Double-Blind Method; Female; Fluticasone; Humans; Male; Middle Aged; Prednisolone

Fluticasone propionate is a new corticosteroid with low systemic bioavailability. This study reports the outcome of a double blind clinical trial comparing oral fluticasone propionate (5 mg four times daily) with placebo for the treatment of active distal ulcerative colitis. Sixty patients were treated for four weeks, with assessments at two and four weeks. One patient was withdrawn when she was found to have amoebiasis. Thus, results are presented for 29 patients who received placebo and 30 who received fluticasone propionate. The two groups were well matched for age, sex, length of history, and extent of disease. After four weeks of therapy the clinical, sigmoidoscopic, and histological responses were similar in the two groups. It is concluded that fluticasone propionate (5 mg four times daily) is not effective treatment for active distal ulcerative colitis.

Topics: Administration, Oral; Adolescent; Adrenal Cortex Hormones; Adult; Aged; Androstadienes; Colitis, Ulcerative; Double-Blind Method; Female; Fluticasone; Humans; Hydrocortisone; Male; Middle Aged

Ulcerative colitis is common types of severe, progressive, idiopathic inflammatory bowel disease that involves the mucosal lining of the large intestine. The purpose of the study is to explore the effects of hecogenin in TNBS (2, 4, 6- trinitrobenzene sulfonic acid) induced ulcerative colitis model in rats.. Thirty Wistar rats were randomized into five groups: (i) Normal Control (NC), (ii) Disease Control (DC), (iii) Hecogenin (HG) (50 µg/rat), (iv) Fluticasone (FC) (50 µg/rat), (v) Hecogenin + Fluticasone (HG + FC) combination (25 µg/rat). Colitis was induced by trans-rectal administration of TNBS using a catheter inserted 8 cm into the rectal portion of the rat. Colitis was evaluated by an independent observer who was blinded to the treatment. All treatment group results were compared to the TNBS group results.. The study results revealed that treatment of rats with HG and HG + FC significantly improved the body weight and colon length whereas; decreased the spleen weight, colon weight/length ratio, macroscopic lesions score, diarrhea score and adhesion score. The drug treatment in rats substantially decreased the development of inflammatory cytokines, levels of serum immunoglobulin E, colonic nitric oxide contents and restoration of antioxidant stress markers. Histopathological colon sample study significantly reduced colonic inflammation with a substantial decrease in inflammation score.. Thus, HG and HG + FC combination could change the pathogenesis of the disease and may be a potential therapeutic target for the treatment of ulcerative colitis by a reduction in dose in conjunction with FC to prevent the persistent adverse effects associated with FC.

Topics: Animals; Anti-Inflammatory Agents; Antioxidants; Colitis, Ulcerative; Down-Regulation; Drug Therapy, Combination; Female; Fluticasone; Inflammation Mediators; Male; Mice; Oxidative Stress; Rats; Rats, Wistar; Sapogenins; Trinitrobenzenesulfonic Acid

Topics: Androstadienes; Anti-Inflammatory Agents; Bronchitis; Colitis, Ulcerative; Fluticasone; Humans; Male; Middle Aged; Prednisone; Respiratory Sounds; Tracheitis

Topics: Administration, Topical; Androstadienes; Anti-Inflammatory Agents; Beclomethasone; Betamethasone Valerate; Budesonide; Colitis, Ulcerative; Fluticasone; Glucocorticoids; Humans; Hydrocortisone; Prednisolone; Pregnenediones