Wolfgang Stremmel, MD; Robert Ehehalt, MD; Frank Autschbach, MD; Max Karner, MD
Acknowledgment: The authors thank Susanne Schäfer for statistical analysis; Annika Braun, MD, and Alexandra Zahn, MD, for assistance in patient management; and Heather Karner, MA, for proofreading and editing services. They also thank Verena Schmieg and Anja Hanemann for assistance in assessing the follow-up data and Daniela Kautz and Anja Hanemann for assisting in the data management and graph generation.
Grant Support: By the Dietmar-Hopp Foundation (Dr. Stremmel).
Potential Financial Conflicts of Interest: Grants received: W. Stremmel (Dietmar-Hopp Foundation). Patents received: W. Stremmel (for retarded-release phosphatidylcholine as a mucoprotective agent for the large intestine.)
Reproducible Research Statement: The protocol (in German, with an English-language synopsis), data set, and statistical code are available to interested readers by contacting Dr. Stremmel (e-mail, email@example.com).
Requests for Single Reprints: Wolfgang Stremmel, MD, Department of Gastroenterology, University Hospital Heidelberg, Im Neuenheimer Feld 410, D-69120 Heidelberg, Germany; e-mail, firstname.lastname@example.org.
Current Author Addresses: Drs. Stremmel, Ehehalt, and Karner: Department of Gastroenterology, University Hospital Heidelberg, Im Neuenheimer Feld 410, D-69120 Heidelberg, Germany.
Dr. Autschbach: Pathological Institute, University Hospital Heidelberg, Im Neuenheimer Feld 220/221, 69120 Heidelberg, Germany.
Author Contributions: Conception and design: W. Stremmel, M. Karner.
Analysis and interpretation of the data: W. Stremmel, R. Ehehalt, M. Karner.
Drafting of the article: W. Stremmel, M. Karner.
Critical revision of the article for important intellectual content: W. Stremmel, M. Karner.
Final approval of the article: W. Stremmel, R. Ehehalt, F. Autschbach, M. Karner.
Provision of study materials or patients: W. Stremmel, F. Autschbach, M. Karner.
Statistical expertise: W. Stremmel, M. Karner.
Obtaining of funding: W. Stremmel.
Administrative, technical, or logistic support: W. Stremmel, R. Ehehalt, M. Karner.
Collection and assembly of data: W. Stremmel, R. Ehehalt, F. Autschbach, M. Karner.
Stremmel W, Ehehalt R, Autschbach F, Karner M. Phosphatidylcholine for Steroid-Refractory Chronic Ulcerative Colitis: A Randomized Trial. Ann Intern Med. 2007;147:603-610. doi: 10.7326/0003-4819-147-9-200711060-00004
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Published: Ann Intern Med. 2007;147(9):603-610.
Long-term steroid therapy is harmful and should be replaced by immunosuppressant drugs, such as azathioprine or 6-mercaptopurine, in chronic active ulcerative colitis. Treatment alternatives are lacking, however, when immunosuppressant drugs cause adverse events, fail, or are rejected by patients. In such cases, patients must endure long-term steroid therapy.
A new therapeutic strategy with phosphatidylcholine supplementation in the colonic mucus has been developed. It is based on the pathogenetic concept of a mucosal barrier dysfunction in ulcerative colitis caused by a primary lack of the mucoprotective phosphatidylcholine in colonic mucus (1–4). Because ingestion of phosphatidylcholine leads to complete absorption in the upper intestine and topical rectal applications of phosphatidylcholine do not integrate into the mucus, phosphatidylcholine was encapsulated with Eudragit-S100 (Röhm Pharma, Darmstadt, Germany) to provide pH-dependent release in the distal intestine (5).
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Gastroenterology/Hepatology, Inflammatory Bowel Disease.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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