Ridogrel enemas in distal ulcerative colitis

Objective To evaluate the effect of Ridogrel enemas (Janssen Research Found ation, Beerse, Belgium) on disease activity and mucosal inflammatory mediat ors in patients with active left-sided ulcerative colitis. Design and methods Eleven patients with active left-sided ulcerative coliti s were evaluated in an open nonplacebo-controlled pilot study. All patients were treated with Ridogrel enemas (300 mg/40 ml once daily) over four week s. A disease activity score based on clinical, endoscopic and histological criteria was obtained before and after treatment with Ridogrel. The concent rations of thromboxane B-2 (TxB(2)), prostaglandin E-2 (PGE(2)), interteuki n-6 (IL-6) and tumour necrosis factor alpha (TNF-alpha) were measured in mu cosal biopsies before and after treatment, Results One patient discontinued treatment because of progression of diseas e, the other ten patients tolerated the Ridogrel enemas well, Mucosal TxB(2 ) concentration decreased significantly in all patients, The mucosal concen trations of the other inflammatory mediators (PGE(2,) IL-6 and TNF-alpha) w ere unaltered. The disease score decreased in five patients. However, clini cal improvement was not always associated with a decrease in endoscopic and /or histological scores. Conclusions This pilot study shows that Ridogrel enemas selectively reduce mucosal TxB(2) concentration. Eur J Gastroenterol Hepatol 13:397-400 (C) 20 01 Lippincott Williams & Wilkins.