Abstract
Patients with ulcerative colitis uniformly have disease involving the distal colon. When patients have disease limited to the left colon or symptoms suggestive of active rectal inflammation, guidelines recommend topical rectal therapies as first-line agents either as monotherapy or in conjunction with oral products. Rectal delivery modalities offer the advantage of delivering high local concentrations of active medication to the site of maximal inflammation with minimization of systemic side effects. Methods of rectal administration include suppositories, liquid enemas and foams. Suppositories are limited to the treatment of rectal disease, and patients often have difficulty retaining the liquid enema secondary to its high volume and consistency. Rectal foams reliability extend to the descending and sigmoid colon with application. Foams are further characterized by increased viscosity, lower volumes, finer dispersion on the colonic mucosa, and increased adhesiveness to the colonic mucosa compared with liquid enemas. Additionally, rectal foam agents demonstrate equal efficacy to their liquid enema counterparts yet consistently yield better patient tolerance, lower incidence of side effects, and increased patient acceptability. Currently available agents include 5-aminosalicylic acid and corticosteroids, both first and newer generation. This review focuses on clinical trials assessing efficacy, tolerability, and patient preferences for these agents as well as describing the currently available rectal foam products.
Keywords: Ulcerative colitis, proctitis, enemas, foam preparations, 5-aminosalicylic acid, corticosteroids, systematic review
Current Drug Delivery
Title:Foam Preparations for the Treatment of Ulcerative Colitis
Volume: 9 Issue: 4
Author(s): Burr J. Loew and Corey A. Siegel
Affiliation:
Keywords: Ulcerative colitis, proctitis, enemas, foam preparations, 5-aminosalicylic acid, corticosteroids, systematic review
Abstract: Patients with ulcerative colitis uniformly have disease involving the distal colon. When patients have disease limited to the left colon or symptoms suggestive of active rectal inflammation, guidelines recommend topical rectal therapies as first-line agents either as monotherapy or in conjunction with oral products. Rectal delivery modalities offer the advantage of delivering high local concentrations of active medication to the site of maximal inflammation with minimization of systemic side effects. Methods of rectal administration include suppositories, liquid enemas and foams. Suppositories are limited to the treatment of rectal disease, and patients often have difficulty retaining the liquid enema secondary to its high volume and consistency. Rectal foams reliability extend to the descending and sigmoid colon with application. Foams are further characterized by increased viscosity, lower volumes, finer dispersion on the colonic mucosa, and increased adhesiveness to the colonic mucosa compared with liquid enemas. Additionally, rectal foam agents demonstrate equal efficacy to their liquid enema counterparts yet consistently yield better patient tolerance, lower incidence of side effects, and increased patient acceptability. Currently available agents include 5-aminosalicylic acid and corticosteroids, both first and newer generation. This review focuses on clinical trials assessing efficacy, tolerability, and patient preferences for these agents as well as describing the currently available rectal foam products.
Export Options
About this article
Cite this article as:
J. Loew Burr and A. Siegel Corey, Foam Preparations for the Treatment of Ulcerative Colitis, Current Drug Delivery 2012; 9 (4) . https://dx.doi.org/10.2174/156720112801323062
DOI https://dx.doi.org/10.2174/156720112801323062 |
Print ISSN 1567-2018 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5704 |
Call for Papers in Thematic Issues
Advances of natural products, bio-actives and novel drug delivery system against emerging viral infections
Due to the increasing prevalence of viral infections and the ability of these human pathogens to develop resistance to current treatment strategies, there is a great need to find and develop new compounds to combat them. These molecules must have low toxicity, specific activity and high bioavailability. The most suitable ...read more
Electrospun Fibers as Drug Delivery Systems
In recent years, electrospun fibers have attracted considerable attention as potential platforms for drug delivery due to their distinctive properties and adaptability. These fibers feature a notable surface area-to-volume ratio and can be intentionally designed with high porosity, facilitating an increased capacity for drug loading and rendering them suitable for ...read more
Emerging Nanotherapeutics for Mitigation of Neurodegenerative Disorders
Conditions affecting the central nervous system (CNS) present a significant hurdle due to limited access of both treatments and diagnostic tools for the brain. The blood-brain barrier (BBB) acts as a barrier, restricting the passage of molecules from the bloodstream into the brain. The most formidable challenge facing scientists is ...read more
Nanotechnology Based Chemotherapy for the treatment of Head & Neck Cancer
The escalating recurrence rates observed in Head and Neck cancer, particularly within the chemo-therapeutically treated cohort (50-60%), can be attributed to the non-selective nature of current anticancer drug delivery modalities. In this context, nanotechnology-based drug delivery systems emerge as a promising avenue for achieving precise localization of therapeutic agents to ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
Related Articles
-
Clozapine Safety, 35 Years Later
Current Drug Safety Sulforaphane Treatment of Young Men with Autism Spectrum Disorder
CNS & Neurological Disorders - Drug Targets Cortisol Regulation in the Metabolic Syndrome. A Novel Therapeutic Approach
Immunology, Endocrine & Metabolic Agents in Medicinal Chemistry (Discontinued) Central Nervous System Acting Drugs in Treatment of Migraine Headache
Central Nervous System Agents in Medicinal Chemistry Reproductive Effects of Low-to-Moderate Medical Radiation Exposure
Current Medicinal Chemistry The Role of Corticosteroids in Sepsis and Acute Respiratory Distress Syndrome
Current Respiratory Medicine Reviews Somatostatin Involvement in Rheumatoid Arthritis
Current Rheumatology Reviews Physiological and Pathological Functions of Acid-Sensing Ion Channels in the Central Nervous System
Current Drug Targets Weight Loss in Older Persons: New Therapeutic Approaches
Current Pharmaceutical Design Contribution of Catecholamine Reactive Intermediates and Oxidative Stress to the Pathologic Features of Heart Diseases
Current Medicinal Chemistry Psychological Stress in Pathogenesis of Essential Hypertension
Current Hypertension Reviews Prostaglandins Pathway as a Possible Biological Link Between Cancer and Major Depression
Current Angiogenesis (Discontinued) The Cell Cycle and Hormonal Fluxes in Alzheimer Disease: A Novel Therapeutic Target
Current Pharmaceutical Design Towards an Evidence-based Model of Aging
Current Aging Science Testosterone as Potential Effective Therapy in Treatment of Obesity in Men with Testosterone Deficiency: A Review
Current Diabetes Reviews Combining Stress and Dopamine Based Models of Addiction: Towards a Psycho-Neuro-Endocrinological Theory of Addiction
Current Drug Abuse Reviews Study of Neonatal Exposure to Estrogenic and Androgenic Endocrine Disruptors by Normal-Phase HPLC
Drug Delivery Letters The Pro-Apoptotic Substance Thapsigargin Selectively Stimulates Re-Growth of Brain Capillaries
Current Neurovascular Research Adipobiology of Diabetes Mellitus
Immunology, Endocrine & Metabolic Agents in Medicinal Chemistry (Discontinued) The Effects of Locus Coeruleus and Norepinephrine in Methamphetamine Toxicity
Current Neuropharmacology