Last Updated: 2007-04-20 (Reuters Health)

NEW YORK (Reuters Health) Apr 20 - In patients with severe attacks of ulcerative colitis, continuous infusion of methylprednisolone offers no advantages over bolus administration, Italian researchers report in the April issue of the American Journal of Gastroenterology.

"Continuous IV injection is still used, based on the hypothesis of better symptom control and less side effects, " Dr. Vito Annese told Reuter Health. "This study simply demonstrates that this is not the case."

Dr. Annese and colleagues at Ospedale I.R.C.C.S. "Casa Sollievo della Sofferenza," S. Giovanni Rotondo note that IV steroid administration is generally first-line treatment in such patients and leads to improvement in as many as 60%.

Bolus administration is widely employed and the researchers sought to determine whether continuous infusion might be a more effective approach.

To investigate further, the team randomized 66 patients with a severe attack of ulcerative colitis to treatment by continuous infusion or by bolus injection of 1 mg/kg per day of 6-methyl-prednisolone.

After 7 days of treatment, the outcome was identical, with 17 of the 34 patients given continuous infusion showing remission compared to 16 of the 32 who received a bolus injection.

A steroid-related adverse reaction occurred in 13 of the continuous infusion group and 15 of the bolus group. In the following month, 5 patients in each group underwent total colectomy.

Continuous infusion, the researchers point out, neither enhanced the rate of clinical response nor affected the frequency of steroid-related adverse events.

They therefore conclude that "the easier modality, that is, bolus injection, could be preferable in ulcerative colitis patients during a severe attack of the disease."

Date Posted: May 17, 2007