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Non-pathogenic Escherichia coli versus mesalazine for the treatment of ulcerative colitis: a randomised trial.

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Title: Non-pathogenic Escherichia coli versus mesalazine for the treatment of ulcerative colitis: a randomised trial.
Authors: Rembacken BJ (AUTHOR), Snelling AM (AUTHOR), Hawkey PM (AUTHOR), Chalmers DM (AUTHOR), Axon ATR (AUTHOR), Rembacken, B J (AUTHOR), Snelling, A M (AUTHOR), Hawkey, P M (AUTHOR), Chalmers, D M (AUTHOR), Axon, A T (AUTHOR)
Source: Lancet. 8/21/1999, Vol. 354 Issue 9179, p635-639. 5p.
Abstract: Background: Ulcerative colitis has been suggested to be caused by infection and there is circumstantial evidence linking Escherichia coli with the condition. Our aim was to find out whether the administration of a non-pathogenic strain of E. coli (Nissle 1917) was as effective as mesalazine in preventing relapse of ulcerative colitis. We also examined whether the addition of E. coli to standard medical therapy increased the chance of remission of active ulcerative colitis.Methods: This was a single-centre, randomised, double-dummy study in which 120 patients with active ulcerative colitis were invited to take part. 116 patients accepted; 59 were randomised to mesalazine and 57 to E. coli. All patients also received standard medical therapy together with a 1-week course of oral gentamicin. After remission, patients were maintained on either mesalazine or E. coli and followed up for a maximum of 12 months. A two-stage, conditional, intention-to-treat analysis was done.Findings: 44 (75%) patients in the mesalazine group attained remission compared with 39 (68%) in the E. coli group. Mean time to remission was 44 days (median 42) in the mesalazine group and 42 days (median 37) for those treated with E. coli. In the mesalazine group, 32 (73%) patients relapsed compared with 26 (67%) in the E. coli group. Mean duration of remission was 206 days in the mesalazine group (median 175) and 221 days (median 185) in the E. coli group.Interpretation: Our results suggest that treatment with a non-pathogenic E. coli has an equivalent effect to mesalazine in maintaining remission of ulcerative colitis. The beneficial effect of live E. coli may provide clues to the cause of ulcerative colitis. [ABSTRACT FROM AUTHOR]
Copyright of Lancet is the property of Lancet and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Non-pathogenic Escherichia coli versus mesalazine for the treatment of ulcerative colitis: a randomised trial.
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  Data: <searchLink fieldCode="AR" term="%22Rembacken+BJ%22">Rembacken BJ</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Snelling+AM%22">Snelling AM</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hawkey+PM%22">Hawkey PM</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Chalmers+DM%22">Chalmers DM</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Axon+ATR%22">Axon ATR</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Rembacken%2C+B+J%22">Rembacken, B J</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Snelling%2C+A+M%22">Snelling, A M</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hawkey%2C+P+M%22">Hawkey, P M</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Chalmers%2C+D+M%22">Chalmers, D M</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Axon%2C+A+T%22">Axon, A T</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Lancet%22">Lancet</searchLink>. 8/21/1999, Vol. 354 Issue 9179, p635-639. 5p.
– Name: Abstract
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  Data: <bold>Background: </bold>Ulcerative colitis has been suggested to be caused by infection and there is circumstantial evidence linking Escherichia coli with the condition. Our aim was to find out whether the administration of a non-pathogenic strain of E. coli (Nissle 1917) was as effective as mesalazine in preventing relapse of ulcerative colitis. We also examined whether the addition of E. coli to standard medical therapy increased the chance of remission of active ulcerative colitis.<bold>Methods: </bold>This was a single-centre, randomised, double-dummy study in which 120 patients with active ulcerative colitis were invited to take part. 116 patients accepted; 59 were randomised to mesalazine and 57 to E. coli. All patients also received standard medical therapy together with a 1-week course of oral gentamicin. After remission, patients were maintained on either mesalazine or E. coli and followed up for a maximum of 12 months. A two-stage, conditional, intention-to-treat analysis was done.<bold>Findings: </bold>44 (75%) patients in the mesalazine group attained remission compared with 39 (68%) in the E. coli group. Mean time to remission was 44 days (median 42) in the mesalazine group and 42 days (median 37) for those treated with E. coli. In the mesalazine group, 32 (73%) patients relapsed compared with 26 (67%) in the E. coli group. Mean duration of remission was 206 days in the mesalazine group (median 175) and 221 days (median 185) in the E. coli group.<bold>Interpretation: </bold>Our results suggest that treatment with a non-pathogenic E. coli has an equivalent effect to mesalazine in maintaining remission of ulcerative colitis. The beneficial effect of live E. coli may provide clues to the cause of ulcerative colitis. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Lancet is the property of Lancet and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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