Comparison of Heparin and Steroids in the Treatment of moderate and severeulcerative colitis

Background & Aims: Unfractionated heparin has been found to reduce symptoms and improve healing as adjuvant therapy in patients with ulcerative coliti s, The current study evaluated the efficacy and safety of unfractionated he parin in the treatment of ulcerative colitis in comparison with methylpredn isolone, Methods: A multicenter randomized trial with blinded endpoint eval uation was conducted in patients hospitalized for moderate or severe ulcera tive colitis, Patients were randomized to receive heparin as a continuous i nfusion or methylprednisolone (0.75-1 mg.kg(-1).day(-1)), Results: Twenty-f ive patients entered the study: 13 received methylprednisolone and 12 recei ved heparin, By day 10, 69% of patients in the methylprednisolone group, bu t none in the heparin group, achieved significant improvement or remission, C-reactive protein levels significantly decreased in the methylprednisolon e group but not in the heparin group, Three patients in the heparin group w ere withdrawn before day 10 because of an adverse event: rectal bleeding ne eding transfusion (2 cases) or surgery (1 case). The proportion of patients with persistent rectal bleeding at day 10 was 31% in the methylprednisolon e group and 90% in the heparin group (P < 0.05), Conclusions: Unfractionate d heparin as monotherapy is not effective in the treatment of moderate or s evere ulcerative colitis and is associated with significant bleeding compli cations.