Rosiglitazone for active ulcerative colitis: A randomized placebo-controlled trial

被引:188
作者
Lewis, James D. [1 ,2 ,3 ,4 ]
Lichtenstein, Gary R. [1 ,3 ]
Deren, Julius J. [1 ,3 ]
Sands, Bruce E. [5 ]
Hanauer, Stephen B. [6 ]
Katz, Jeffrey A. [7 ]
Lashner, Bret [8 ]
Present, Daniel H. [9 ]
Chuai, Shaokun [2 ,4 ]
Ellenbergr, Jonas H. [2 ,4 ]
Nessel, Lisa [2 ]
Wu, Gary D. [1 ,3 ]
机构
[1] Univ Penn, Sch Med, Div Gastroenterol, Philadelphia, PA 19104 USA
[2] Univ Penn, Sch Med, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA
[3] Univ Penn, Sch Med, Dept Med, Philadelphia, PA 19104 USA
[4] Univ Penn, Sch Med, Dept Biostat & Epidemiol, Philadelphia, PA 19104 USA
[5] Massachusetts Gen Hosp, Boston, MA 02114 USA
[6] Univ Chicago, Chicago, IL 60637 USA
[7] Case Western Reserve Univ, Cleveland, OH 44106 USA
[8] Cleveland Clin, Cleveland, OH 44106 USA
[9] Mt Sinai Sch Med, New York, NY USA
关键词
D O I
10.1053/j.gastro.2007.12.012
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background&Aims: Thiazolidinedione ligands for the gamma subtype of peroxisome proliferatoractivated receptors (PPAR gamma), widely used to treat type 2 diabetes mellitus, have been proposed as novel therapies for ulcerative colitis (UC). Methods: This multicenter, randomized, double-blind, placebocontrolled clinical trial compared the efficacy of rosightazone (Avandia; GlaxoSmithKhne, Philadelphia, PA) 4 mg orally twice daily vs placebo twice daily for 12 weeks in 105 patients with mild to moderately active UC. Disease activity was measured with the Mayo score. The primary end point was clinical response (>= 2-point reduction) at week 12. Clinical remission (Mayo score <= 2), endoscopic remission, and quality of life were secondary outcomes. Results: After 12 weeks of therapy, 23 patients (44%) treated with rosiglitazone and 12 patients (23%) treated with placebo achieved clinical response (P = .04). Remission was achieved in 9 patients (17%) treated with rosightazone and I patient (2%) treated with placebo (P = .01). Endoscopic remission was uncommon in either treatment arm (8% rosiglitazone vs 2% placebo; P = .34). Clinical improvement was evident as early as 4 weeks after beginning treatment (P = .049). Quality of life was improved significantly at week 8 (P = .01), but not at week 4 (P = .48) or week 12 (P = .14). Serious adverse events were rare. Conclusions: Rosightazone was efficacious in the treatment of mild to moderately active UC.
引用
收藏
页码:688 / 695
页数:8
相关论文
共 40 条
[1]   Peroxisome proliferator activated receptor γ in colonic epithelial cells protects against experimental inflammatory bowel disease [J].
Adachi, M. ;
Kurotani, R. ;
Morimura, K. ;
Shah, Y. ;
Sanford, M. ;
Madison, B. B. ;
Gumucio, D. L. ;
Marin, H. E. ;
Peters, J. M. ;
Young, H. A. ;
Gonzalez, F. J. .
GUT, 2006, 55 (08) :1104-1113
[2]  
Armitage P, 1987, Statistical methods in medical research, V2nd
[3]   PPAR-γ dependent and independent effects on macrophage-gene expression in lipid metabolism and inflammation [J].
Chawla, A ;
Barak, Y ;
Nagy, L ;
Liao, D ;
Tontonoz, P ;
Evans, RM .
NATURE MEDICINE, 2001, 7 (01) :48-52
[4]   Calprotectin is a stronger predictive marker of relapse in ulcerative colitis than in Crohn's disease [J].
Costa, F ;
Mumolo, MG ;
Ceccarelli, L ;
Bellini, M ;
Romano, MR ;
Sterpi, C ;
Ricchiuti, A ;
Marchi, S ;
Bottai, M .
GUT, 2005, 54 (03) :364-368
[5]   A review of activity indices and efficacy end points for clinical trials of medical therapy in adults with ulcerative colitis [J].
D'Haens, Geert ;
Sandborn, William J. ;
Feagan, Brian G. ;
Geboes, Karel ;
Hanauer, Stephen B. ;
Irvine, E. Jan ;
Lemann, Marc ;
Marteau, Philippe ;
Rutgeerts, Paul ;
Scholmerich, Jurgen ;
Sutherland, Lloyd R. .
GASTROENTEROLOGY, 2007, 132 (02) :763-786
[6]   Uncertain effects of rosiglitazone on the risk for myocardial infarction and cardiovascular death [J].
Diamond, George A. ;
Bax, Leon ;
Kaul, Sanjay .
ANNALS OF INTERNAL MEDICINE, 2007, 147 (08) :578-581
[7]   PPARγ as a new therapeutic in inflammatory bowel diseases [J].
Dubuquoy, L. ;
Rousseaux, C. ;
Thuru, X. ;
Peyrin, L. -Biroulet ;
Romano, O. ;
Chavatte, P. ;
Chamaillard, M. ;
Desreumaux, P. .
GUT, 2006, 55 (09) :1341-1349
[8]   The risk of colorectal cancer in ulcerative colitis: a meta-analysis [J].
Eaden, JA ;
Abrams, KR ;
Mayberry, JF .
GUT, 2001, 48 (04) :526-535
[9]   Placebo response in two long-term randomized psoriasis studies that were negative for rosiglitazone [J].
Ellis, Charles N. ;
Barker, Jonathan N. ;
Haig, Ann E. ;
Parker, Christine A. ;
Daly, Susan ;
Jayawardene, Deepthi A. .
AMERICAN JOURNAL OF CLINICAL DERMATOLOGY, 2007, 8 (02) :93-102
[10]   The organization, promoter analysis, and expression of the human PPAR gamma gene [J].
Fajas, L ;
Auboeuf, D ;
Raspe, E ;
Schoonjans, K ;
Lefebvre, AM ;
Saladin, R ;
Najib, J ;
Laville, M ;
Fruchart, JC ;
Deeb, S ;
VidalPuig, A ;
Flier, J ;
Briggs, MR ;
Staels, B ;
Vidal, H ;
Auwerx, J .
JOURNAL OF BIOLOGICAL CHEMISTRY, 1997, 272 (30) :18779-18789