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P348 Effectiveness budesonide in patients with Crohn's disease
S128
Abstracts
I European
Journal
of Internal
Differences between those on PI and those on NNRTI were statistically significant (p=O.Oill). Both univariate and multivariate analyses identified as risk factors for hepatotoxicity, positive HCV serology [OR, 2.1; 95% CI, 1.2-3.61, alcohol intake [OR, 3.2; 95% CI, 1.7-5.9) and treatment with NNRTIs [OR, 2.5; 95% CI, 1.3-4.51. Conclusions: Avoidance of alcohol intake, eventual control of chronic hepatitis C and use of NNRTI-sparing regimens should be considered when HAART is initiated.
P347 Effectiveness J.L. Mendoza, (Madrid, E)
of topical R. Lana,
steroids in ulcerative colitis A.I. L&da, .I. Garcia-Paredes,
M. Diaz-Rubio
Background: Hydrocortisone in topical formulation reaches splenic flexure of the colon in 80% of the cases; it is a good option in the treatment of active distal ulcerative colitis (UC) but budesonide is a good alternative due to its high topical activity with relatively low sistemic absortion and few side-effects, Aim: To evaluate the effectiveness of budesonide enemas in the induction of remission in patients with active UC and to compare it with topical hydrocortisone. Methods: Descriptive, retrospective, opened and not controlled study by review of clinical histories excluding those patients with irregular follow-up or prescription made in another center. Results:Of a total of 272 patients with UC diagnosed. 107 received budesonide enemas (39.3%): 67 with distal UC (63%) and 40 with more extensive forms (37%). Mean duration of treatment was 33 days [lo-91 days]. 36 patients with distal UC (53.7%) and 16 with more extensive forms (40%) associated oral mesalazine; sistemic mesalazine and corticosteroids, 19 (28.4%) and 21 (52.5%) respectively. 8 patients displayed adverse events (7.5%); half of them treated with sistemic corticosteroids too. 88 patients used topical hydrocortisone (32.4%): 58 with distal UC (66%) and 30 with more extensive forms (34%). In the first group, 8 patients associated topical mesalazine (13.8%) and 29, oral mesalazine (50%); in the second group, all the patients received oral mesalazine and 21 sistemic corticosteroids (70%).
Bvde\omdr
Complrc
PanIsI
so
re\pon\s
reipanw
rerpunw
D~rtalUC
4.5(666?1’
II 1l67%1
,I 116752)
Ex,m\,*r UC/
27 (h75%1
7 CIh.?J%l
b(lh?S%l
Complete
Pam
Ku
rrpme
re\pon\e
re\pon\r
D,atalUC
S? ~9n‘k)*
3 ISa)
3 (WI
Ex,en\we UC/
23 176.6%,
6 ,?O’ij
I (3.W
Medicine
14 (2003)
Sl-S159
Background: Conventional glucocorticosteroids are drugs of proven effectiveness in the treatment of active Inflammatory Bowel Disease (IBD); nevertheless, its limited utility in maintenance of remission, and the frecuent appearance of adverse events has favored the development of new corticosteroids like budesonide. Aim: To evaluate the effectiveness of budesonide, oral and rectal, in patients with Crohn’s Disease (CD) controlled in our center. Methods: Descriptive, retrospective, opened and not controlled study by review of clinical histories. Exclusion criteria: prescription in another center and irregular follow-up. Results: Budesonide was administered in 62 of 247 diagnosed patients of CD (25.1%): oral in 55 (88.7%) and rectal in 7 (11.3%). Indications orally were: induction of remission in mild to moderate active CD in 30 cases (54.5%). maintenance of the same one in 16 (29.1%). prophylaxis of recurrence in 6 (10.9%) and switching from conventional steroids in steroid-dependent patients in 3 (5.5%). The mean time of treatment was of 158, 656, 504 and 630 days respectively. 11 patients of the first group received mesalazine at the same time, 7 of the second and all others. Side-effects own of steroids appeared in 6 patients; 4 in the group of maintenaince of remission, one steroid-dependent and one operated patients. All the cases in which it was administered rectally were active CD of the colon, associated to oral mesalazine or metilprednisolone; during 53 days of mean time without registering adverse events.
Conclusions: In more than half of patients with mild to moderate active CD, remission was induced without adverse events. When the indication was maintenance of the same one, higher rates of response were obtained. The steroid-dependent or operated patients have required the introduction of other treatments. Administration in enemas was always associated with mesalazine and/or corticosteroids orally.
pmcnlmr Hydrrwn~wnr
P349 Hematologic manifestations of alcohol binge D. Zamir, I. Polychuck, Y. Mishal, I. Leibovitz, (Ashkelon, IL)
drinking T. Reitblat,
G. Lugassy
pmcoliu~ * Dl\tal UC complete reapon\e (budeaonide vs. hydroconirone) p=O.O0?6 (OR=424
IC 95%
l.4612.89).
Conclusions: More than 2/3 of patients with active UC of any extension response to topical budesonide favorably. Hydrocortisone enemas was more effective than budesonide one on actiuve distal UC, although it was associated in greater number of ocassions to topic mesalazine.
P348 Effectiveness budesonide R. Lana, J.L. Mendoza, (Madrid, E)
in patients AI. L&da,
with Crobn’s disease J. Garcia-Paredes, M. Diaz-Rubio
Alcoholism is a major problem in the western world and a growing problem in Israel in the last 2 decades. Binge alcohol drinking is a common pattern of alcohol drinking especially among young males. We present 2 cases of most uncommon hematologic complications of binge alcohol drinking: thrombotic thrombocytopenic purpura and relative thrombocytopenia and discuss their possible mechanisms in these patients.
P350 Effects of chronic use of tobacco on systemic vasodilatation in liver cirrhosis J.L. Alonso-Martinez, J.M. Zozaya-Urmeneta, M.A. Urbieta-Echezarreta, M.L. Abinzano-Guilltn, M. Solano-Remirez, M.T. Alvarez-Frias (Pamplona, E)
Abstracts
I European
Journal
of Internal
Differences between those on PI and those on NNRTI were statistically significant (p=O.Oill). Both univariate and multivariate analyses identified as risk factors for hepatotoxicity, positive HCV serology [OR, 2.1; 95% CI, 1.2-3.61, alcohol intake [OR, 3.2; 95% CI, 1.7-5.9) and treatment with NNRTIs [OR, 2.5; 95% CI, 1.3-4.51. Conclusions: Avoidance of alcohol intake, eventual control of chronic hepatitis C and use of NNRTI-sparing regimens should be considered when HAART is initiated.
P347 Effectiveness J.L. Mendoza, (Madrid, E)
of topical R. Lana,
steroids in ulcerative colitis A.I. L&da, .I. Garcia-Paredes,
M. Diaz-Rubio
Background: Hydrocortisone in topical formulation reaches splenic flexure of the colon in 80% of the cases; it is a good option in the treatment of active distal ulcerative colitis (UC) but budesonide is a good alternative due to its high topical activity with relatively low sistemic absortion and few side-effects, Aim: To evaluate the effectiveness of budesonide enemas in the induction of remission in patients with active UC and to compare it with topical hydrocortisone. Methods: Descriptive, retrospective, opened and not controlled study by review of clinical histories excluding those patients with irregular follow-up or prescription made in another center. Results:Of a total of 272 patients with UC diagnosed. 107 received budesonide enemas (39.3%): 67 with distal UC (63%) and 40 with more extensive forms (37%). Mean duration of treatment was 33 days [lo-91 days]. 36 patients with distal UC (53.7%) and 16 with more extensive forms (40%) associated oral mesalazine; sistemic mesalazine and corticosteroids, 19 (28.4%) and 21 (52.5%) respectively. 8 patients displayed adverse events (7.5%); half of them treated with sistemic corticosteroids too. 88 patients used topical hydrocortisone (32.4%): 58 with distal UC (66%) and 30 with more extensive forms (34%). In the first group, 8 patients associated topical mesalazine (13.8%) and 29, oral mesalazine (50%); in the second group, all the patients received oral mesalazine and 21 sistemic corticosteroids (70%).
Bvde\omdr
Complrc
PanIsI
so
re\pon\s
reipanw
rerpunw
D~rtalUC
4.5(666?1’
II 1l67%1
,I 116752)
Ex,m\,*r UC/
27 (h75%1
7 CIh.?J%l
b(lh?S%l
Complete
Pam
Ku
rrpme
re\pon\e
re\pon\r
D,atalUC
S? ~9n‘k)*
3 ISa)
3 (WI
Ex,en\we UC/
23 176.6%,
6 ,?O’ij
I (3.W
Medicine
14 (2003)
Sl-S159
Background: Conventional glucocorticosteroids are drugs of proven effectiveness in the treatment of active Inflammatory Bowel Disease (IBD); nevertheless, its limited utility in maintenance of remission, and the frecuent appearance of adverse events has favored the development of new corticosteroids like budesonide. Aim: To evaluate the effectiveness of budesonide, oral and rectal, in patients with Crohn’s Disease (CD) controlled in our center. Methods: Descriptive, retrospective, opened and not controlled study by review of clinical histories. Exclusion criteria: prescription in another center and irregular follow-up. Results: Budesonide was administered in 62 of 247 diagnosed patients of CD (25.1%): oral in 55 (88.7%) and rectal in 7 (11.3%). Indications orally were: induction of remission in mild to moderate active CD in 30 cases (54.5%). maintenance of the same one in 16 (29.1%). prophylaxis of recurrence in 6 (10.9%) and switching from conventional steroids in steroid-dependent patients in 3 (5.5%). The mean time of treatment was of 158, 656, 504 and 630 days respectively. 11 patients of the first group received mesalazine at the same time, 7 of the second and all others. Side-effects own of steroids appeared in 6 patients; 4 in the group of maintenaince of remission, one steroid-dependent and one operated patients. All the cases in which it was administered rectally were active CD of the colon, associated to oral mesalazine or metilprednisolone; during 53 days of mean time without registering adverse events.
Conclusions: In more than half of patients with mild to moderate active CD, remission was induced without adverse events. When the indication was maintenance of the same one, higher rates of response were obtained. The steroid-dependent or operated patients have required the introduction of other treatments. Administration in enemas was always associated with mesalazine and/or corticosteroids orally.
pmcnlmr Hydrrwn~wnr
P349 Hematologic manifestations of alcohol binge D. Zamir, I. Polychuck, Y. Mishal, I. Leibovitz, (Ashkelon, IL)
drinking T. Reitblat,
G. Lugassy
pmcoliu~ * Dl\tal UC complete reapon\e (budeaonide vs. hydroconirone) p=O.O0?6 (OR=424
IC 95%
l.4612.89).
Conclusions: More than 2/3 of patients with active UC of any extension response to topical budesonide favorably. Hydrocortisone enemas was more effective than budesonide one on actiuve distal UC, although it was associated in greater number of ocassions to topic mesalazine.
P348 Effectiveness budesonide R. Lana, J.L. Mendoza, (Madrid, E)
in patients AI. L&da,
with Crobn’s disease J. Garcia-Paredes, M. Diaz-Rubio
Alcoholism is a major problem in the western world and a growing problem in Israel in the last 2 decades. Binge alcohol drinking is a common pattern of alcohol drinking especially among young males. We present 2 cases of most uncommon hematologic complications of binge alcohol drinking: thrombotic thrombocytopenic purpura and relative thrombocytopenia and discuss their possible mechanisms in these patients.
P350 Effects of chronic use of tobacco on systemic vasodilatation in liver cirrhosis J.L. Alonso-Martinez, J.M. Zozaya-Urmeneta, M.A. Urbieta-Echezarreta, M.L. Abinzano-Guilltn, M. Solano-Remirez, M.T. Alvarez-Frias (Pamplona, E)