Rectal and colonic mesalazine concentration in ulcerative colitis: oral vs. oral plus topical treatment

Aim : To measure mucosal concentrations of mesalazine in ulcerative colitis patients treated with oral mesalazine alone, compared to patients treated with both topical and oral mesalazine. Methods : Twenty‐two patients with mild to moderate ulcerative colitis were randomized to receive 2.4 g/day of oral mesalazine (11 patients) or 2.4 g/day oral plus 4 g/day of topical mesalazine (11 patients). After 2 weeks of treatment, endoscopic biopsies specimens were taken from the rectum and in descending colon just distal of the splenic flexure and stored to –80 °C for later assay (HPLC). Wilcoxon’s rank sum test for unpaired data was used for the statistical analysis. Results : Mucosal levels of mesalazine in the rectum were significantly higher in patients who received oral plus topical treatment than in those who had oral treatment alone (52.1 ng/mg, range: 13.6–122.1 vs. 0.2 ng/mg, range: 0.2–9.7, respectively; P