Mario Guslandi, MD; Alberto Tittobello, MD
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Guslandi M., Tittobello A.; Transdermal Nicotine for Ulcerative Colitis. Ann Intern Med. 1997;127:492. doi: 10.7326/0003-4819-127-6-199709150-00020
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Published: Ann Intern Med. 1997;127(6):492.
TO THE EDITOR:
We read with great interest the paper by Sandborn and colleagues  on transdermal nicotine for ulcerative colitis. In agreement with their data, we also reported that transdermal nicotine, when added to mesalamine, induces clinical alleviation of mild to moderate ulcerative colitis . In fact, nicotine patches allowed most patients with a history of poor tolerance to corticosteroids to avoid prednisone therapy . Although if administered alone, transdermal nicotine seems less effective than oral steroids in active disease  and no better than placebo as maintenance treatment , we also observed that patients who responded to nicotine were still in clinical remission several weeks after nicotine therapy was discontinued (the previously ongoing maintenance treatment with mesalamine was continued). We also studied patients who had mild to moderate clinical relapses of left-sided ulcerative colitis during maintenance treatment with 1 g of mesalamine twice daily. These patients were randomly allocated to 5 weeks of additional treatment with either transdermal nicotine (15 mg/d) or prednisone (initial dosage, 30 mg/d for 1 week; the dose was then tapered by decreases of 5 mg every 5 days).
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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