Prostanoids cytoprotection for maintaining remission in ulcerative colitis failure of 15(R), 15-methylprostaglandin E2

To establish whether the cytoprotective properties of prostanoids can be used for maintaining remission in ulcerative colitis, 24 patients with ulcerative colitis in remission were randomly assigned to receive either 15(R), 15-methyl-PGE2 (200 micrograms/day) or to continue with sulfasalazine (2.0 g/day) for up to 28 weeks. All patients included were symptom free and sigmoidoscopy and rectal biopsy performed upon entering the trial did not reveal any signs of disease activity. Of the 12 patients who discontinued sulfasalazine and were allocated to receive 15(R), 15-methyl-PGE2, five flared up within the first four weeks and three others had to stop the trial because of severe diarrhea. Because of the high incidence of side effects and flare-up, the other four patients were instructed to stop the trial. In contrast, only two of the 12 sulfasalazine-treated patients flared-up and the other 10 concluded the 28 weeks of the trial symptom free. These results indicate that 15(R), 15-methyl-PGE2 cannot be used to control and support remission in ulcerative colitis patients.