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Mesalazine foam (Salofalk foam) in the treatment of active distal ulcerative colitis. A comparative trial vs Salofalk enema. The SAF-3 study group.
Ital J Gastroenterol Hepatol. 1999 Nov; 31(8):677-84.IJ

Abstract

BACKGROUND

Mesalazine enemas are of well proven efficacy for the topical treatment of distal ulcerative colitis. Although new rectal formulations of mesalazine are not expected to be superior in efficacy and tolerability to standard formulations, they may offer secondary advantages in terms of overall acceptability.

AIM

To compare the efficacy, tolerability and overall acceptability of a new mesalazine rectal foam (Salofalk foam) with mesalazine enema in the treatment of active distal ulcerative colitis.

PATIENTS AND METHODS

A multicentre study was carried out in patients with active proctitis, proctosigmoiditis and left-sided ulcerative colitis as evaluated by the Clinical Activity Index (CAI > or =4) and Endoscopic Index (EI > or =6). Patients were randomly assigned to receive, in open-label fashion, either mesalazine foam 2 g twice a day or mesalazine enema (2 g/60 ml twice a day) for 3 weeks. Patients who did not achieve remission (defined as CAI <4 and EI <6) after 3 weeks continued the study receiving the alternative galenic formulation for a further 3 weeks.

RESULTS

A total of 195 patients were enrolled. Characteristics at baseline were similar except for concomitant therapy with oral 5-ASA products: during the 1st treatment phase, 41% of patients on enema received such treatment vs only 29% of those on foam. Patients with at least one post-treatment efficacy evaluation were included in the intent-to-treat analysis (n=89 foam, n=96 enema). After 3 weeks of treatment, 112 patients were in remission and only 59 patients entered the 2nd treatment phase thus providing data on acceptability. Remission was achieved after 3 weeks in 54% of patients treated with foam and in 67% of those treated with enema. The 90% confidence interval for the difference in remission rates was 0 to 24 and thus within the clinically acceptable range of therapeutic equivalence. At the end of the 2nd phase, 70% of patients switched to foam were in remission vs 65% to the enema. Two patients discontinued treatment with foam prematurely due to anal burning. No clinically important changes were seen in the laboratory tests.

CONCLUSIONS

Salofalk foam and enema are equally effective for the treatment of proctitis, proctosigmoiditis and left-sided ulcerative colitis. The new foam preparation is as well tolerated and accepted as enemas and can be used as a therapeutic alternative to conventional mesalazine enema formulations.

Authors+Show Affiliations

L. Sacco University Hospital, Milan, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Clinical Trial, Phase III
Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10730559

Citation

Ardizzone, S, et al. "Mesalazine Foam (Salofalk Foam) in the Treatment of Active Distal Ulcerative Colitis. a Comparative Trial Vs Salofalk Enema. the SAF-3 Study Group." Italian Journal of Gastroenterology and Hepatology, vol. 31, no. 8, 1999, pp. 677-84.
Ardizzone S, Doldo P, Ranzi T, et al. Mesalazine foam (Salofalk foam) in the treatment of active distal ulcerative colitis. A comparative trial vs Salofalk enema. The SAF-3 study group. Ital J Gastroenterol Hepatol. 1999;31(8):677-84.
Ardizzone, S., Doldo, P., Ranzi, T., Sturniolo, G. C., Giglio, L. A., Annese, V., D'Arienzo, A., Gaia, E., Gullini, S., Riegler, G., Valentini, M., Massa, P., Del Piano, M., Rossini, F., Guidetti, C. S., Pera, A., Greinwald, R., & Bianchi Porro, G. (1999). Mesalazine foam (Salofalk foam) in the treatment of active distal ulcerative colitis. A comparative trial vs Salofalk enema. The SAF-3 study group. Italian Journal of Gastroenterology and Hepatology, 31(8), 677-84.
Ardizzone S, et al. Mesalazine Foam (Salofalk Foam) in the Treatment of Active Distal Ulcerative Colitis. a Comparative Trial Vs Salofalk Enema. the SAF-3 Study Group. Ital J Gastroenterol Hepatol. 1999;31(8):677-84. PubMed PMID: 10730559.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mesalazine foam (Salofalk foam) in the treatment of active distal ulcerative colitis. A comparative trial vs Salofalk enema. The SAF-3 study group. AU - Ardizzone,S, AU - Doldo,P, AU - Ranzi,T, AU - Sturniolo,G C, AU - Giglio,L A, AU - Annese,V, AU - D'Arienzo,A, AU - Gaia,E, AU - Gullini,S, AU - Riegler,G, AU - Valentini,M, AU - Massa,P, AU - Del Piano,M, AU - Rossini,F, AU - Guidetti,C S, AU - Pera,A, AU - Greinwald,R, AU - Bianchi Porro,G, PY - 2000/3/24/pubmed PY - 2000/3/24/medline PY - 2000/3/24/entrez SP - 677 EP - 84 JF - Italian journal of gastroenterology and hepatology JO - Ital J Gastroenterol Hepatol VL - 31 IS - 8 N2 - BACKGROUND: Mesalazine enemas are of well proven efficacy for the topical treatment of distal ulcerative colitis. Although new rectal formulations of mesalazine are not expected to be superior in efficacy and tolerability to standard formulations, they may offer secondary advantages in terms of overall acceptability. AIM: To compare the efficacy, tolerability and overall acceptability of a new mesalazine rectal foam (Salofalk foam) with mesalazine enema in the treatment of active distal ulcerative colitis. PATIENTS AND METHODS: A multicentre study was carried out in patients with active proctitis, proctosigmoiditis and left-sided ulcerative colitis as evaluated by the Clinical Activity Index (CAI > or =4) and Endoscopic Index (EI > or =6). Patients were randomly assigned to receive, in open-label fashion, either mesalazine foam 2 g twice a day or mesalazine enema (2 g/60 ml twice a day) for 3 weeks. Patients who did not achieve remission (defined as CAI <4 and EI <6) after 3 weeks continued the study receiving the alternative galenic formulation for a further 3 weeks. RESULTS: A total of 195 patients were enrolled. Characteristics at baseline were similar except for concomitant therapy with oral 5-ASA products: during the 1st treatment phase, 41% of patients on enema received such treatment vs only 29% of those on foam. Patients with at least one post-treatment efficacy evaluation were included in the intent-to-treat analysis (n=89 foam, n=96 enema). After 3 weeks of treatment, 112 patients were in remission and only 59 patients entered the 2nd treatment phase thus providing data on acceptability. Remission was achieved after 3 weeks in 54% of patients treated with foam and in 67% of those treated with enema. The 90% confidence interval for the difference in remission rates was 0 to 24 and thus within the clinically acceptable range of therapeutic equivalence. At the end of the 2nd phase, 70% of patients switched to foam were in remission vs 65% to the enema. Two patients discontinued treatment with foam prematurely due to anal burning. No clinically important changes were seen in the laboratory tests. CONCLUSIONS: Salofalk foam and enema are equally effective for the treatment of proctitis, proctosigmoiditis and left-sided ulcerative colitis. The new foam preparation is as well tolerated and accepted as enemas and can be used as a therapeutic alternative to conventional mesalazine enema formulations. SN - 1125-8055 UR - https://www.unboundmedicine.com/medline/citation/10730559/Mesalazine_foam__Salofalk_foam__in_the_treatment_of_active_distal_ulcerative_colitis__A_comparative_trial_vs_Salofalk_enema__The_SAF_3_study_group_ L2 - http://www.diseaseinfosearch.org/result/7285 DB - PRIME DP - Unbound Medicine ER -