Alicaforsen, an Antisense Inhibitor of Intercellular Adhesion Molecule-1, in the Treatment for Left-Sided Ulcerative Colitis and Ulcerative Proctitis.

BACKGROUND: Data on the efficacy of intercellular adhesion molecule-1 antisense oligonucleotide alicaforsen in ulcerative colitis (UC) is inconsistent. METHODS: All patients, who had received at least one dose of alicaforsen, were analyzed retrospectively. Alicaforsen's efficacy was assessed in patients treated for left-sided UC and proctitis by comparing clinical and (if applicable) endoscopic disease activity before/after treatment. RESULTS: Twelve patients were treated for left-sided UC or proctitis. Eleven patients received a 6-week course of a once-daily 240 mg alicaforsen enema formulation. In 1 patient, treatment was discontinued, because it was found to be inefficient. Disease activity measured by the partial Mayo score and 6-point symptom score was significantly reduced after treatment (6.0 vs. 2.4, p = 0.011 and 3.7 vs. 1.4, p = 0.008). Faecal calprotectin showed a trend towards reduction (484.4 vs. 179.5 µg/g, p = 0.063). Clinical improvement was achieved in 10 patients (83.3%). In 7 patients, a relapse occurred (70%). Median duration of clinical improvement was 18.0 weeks (range 1-112). Three patients showed an ongoing improvement of >9 months. No adverse events were reported. CONCLUSIONS: A 6-week course of alicaforsen seemed to be safe and efficacious in inducing clinical improvement in patients with left-sided UC and proctitis. Prolonged clinical improvement was observed in many but not all patients.

[Status of alternative medicine in Crohn disease and ulcerative colitis patents: a questionnaire survey]. / Stellenwert der Komplementärmedizin bei M.-Crohn- und Colitis-ulcerosa-Patienten: Eine Fragebogenerhebung.

BACKGROUND: Patients with M. Crohn or colitis ulcerosa live with a chronic disease. Pharmaceuticals used in convention-al medicine have been proven to be effective but can have strong side-effects. Thus, it is no surprise that affected patients are very interested in complementary and alternative medicine (CAM). OBJECTIVE: The aim of our survey was to investigate the use and the application of CAM by patients with M. Crohn and colitis ulcerosa in Switzerland. PATIENTS AND METHODS: Out-patients of the gastroenterological centre at the University Hospital Bern and of two gastroenterological private practices in a medium-sized city completed a self-administered questionnaire on CAM. Demographic variables, disease-related data, use of different approaches of complementary medicine, attitudes towards and the use of CAM were asked for. RESULTS: Out of 204 mailed questionnaires 71% (144) could be evaluated, 44% from patients of the University Hospital, 56% from patients of the gastroenterological private practices. CAM was used by 47% of the patients. The most commonly used methods of CAM were: homeopathy, traditional Chinese medicine and acupuncture. 67% of the patients benefitted by CAM in the long run, whereas 10.5% suffered a relapse of their disease during CAM therapies. The main reason for the patients to apply to CAM was to complement conventional treatment. CONCLUSION: Our survey points out that the studied out-patients have a strong interest in CAM. It is therefore important that clinical research in the various unconventional therapies will be further promoted.

Ameliorative effect of IDS 30, a stinging nettle leaf extract, on chronic colitis.

BACKGROUND AND AIMS: Anti-TNF-alpha antibodies are very effective in the treatment of acute Crohn's disease, but are limited by the decline of their effectiveness after repeated applications. The stinging nettle leaf extract, IDS 30, is an adjuvant remedy in rheumatic diseases dependent on a cytokine suppressive effect. We investigated the effect of IDS 30 on disease activity of murine colitis in different models. METHODS: C3H.IL-10-/- and BALB/c mice with colitis induced by dextran sodium sulphate (DSS) were treated with either IDS 30 or water. Mice were monitored for clinical signs of colitis. Inflammation was scored histologically, and faecal IL-1beta and mucosal cytokines were measured by ELISA. Mononuclear cell proliferation of spleen and Peyer's patches were quantified by 3H-thymidine. RESULTS: Mice with chronic DSS colitis or IL-10-/- mice treated with IDS 30 clinically and histologically revealed significantly (p < 0.05) fewer signs of colitis than untreated animals. Furthermore, faecal IL-1beta and mucosal TNF-alpha concentrations were significantly lower (p < 0.05) in treated mice. Mononuclear cell proliferation after stimulation with lipopolysaccharide was significantly (p < 0.001) reduced in mice treated with IDS 30. CONCLUSIONS: The long-term use of IDS 30 is effective in the prevention of chronic murine colitis. This effect seems to be due to a decrease in the Th1 response and may be a new therapeutic option for prolonging remission in inflammatory bowel disease.