Mesalazine vanishing time from rectal mucosa following its topical administration

To investigate how long and how much Mesalazine (M) is available inside the rectal mucosa following its topical instillation, in patients (pts) with Ulcerative Colitis (UC).

Two rectal biopsies for M concentration were obtained from 45 UC pts in clinical remission and on oral M treatment (OT), before a 4g enema randomly given to consentient pts every day (Group A, 15 pts), every 2days (Group B, 15 pts) and every 3days (Group C, 15 pts). Two additional biopsies were taken 1, 2 and 3days after the last enema in group A, B and C respectively, at least 10days later. All biopsies were immediately frozen at −80°C for later assay by means of high-performance light chromatography (HPLC). Data were analyzed using Student's t-test.

Mean values±standard deviation of M mucosal concentration (ng/mg of tissue) were 1.32±1.41, 56.1±39.2, 9.65±6.60, and 6.39±5.03 in pts receiving OT alone, groups A, B and C, respectively. Values in Group A were statistically higher (p<0.001) than those in Groups B and C while no differences were found between Groups B and C. Values of OT were lower than groups A, B and C.

M mucosal concentration rapidly decreases 2days after a 4g enema, but after three days is still higher than OT alone. These results may provide data which would be useful to plan topical therapy and improve adherence to treatment.