Prednisolone metasulphobenzoate foam retention enemas suppress the hypothalamo-pituitary-adrenal axis.

Abstract

BACKGROUND:

Corticosteroid enemas represent effective treatment for ulcerative proctitis, but absorption into the systemic circulation may have undesirable metabolic consequences. Prednisolone metasulphobenzoate, a lipophobic corticosteroid derivative, is designed to be absorbed poorly through the recto-sigmoid mucosa, but the effects of foam enema preparations upon the hypothalamo-pituitary-adrenal axis have not been examined.

METHODS:

Nine patients suffering from active ulcerative proctitis underwent four weeks of therapy with prednisolone metasulphobenzoate foam enemas. The hypothalamo-pituitary-adrenal axis, defined using the modified single-dose metyrapone test, glucose homeostasis and lipid profiles were studied before and after treatment.

RESULTS:

The hypothalamo-pituitary-adrenal axis was significantly depressed after the treatment period; mean stimulated plasma cortisol concentration fell from 384 +/- 244 (s.d.) to 288 +/- 252 nmol/L, P < 0.02; stimulated mean plasma 11-deoxycortisol concentration fell from 677 +/- 333 to 407 +/- 326 nmol/L, P < 0.01. Mean fasting plasma glucose, insulin, C-peptide, fructosamine and triglyceride concentration were unchanged, whilst the mean serum cholesterol concentrations rose from 5.6 +/- 1.1 to 6.0 +/- 1.2 mmol/L (not significant).

CONCLUSION:

Prednisolone metasulphobenzoate foam enemas have significant systemic and endocrine metabolic effects, which could assume importance with long-term therapy.

• Authors: W Luman, R S Gray, R Pendek, K R Palmer
• Journal: Alimentary pharmacology & therapeutics (Aliment Pharmacol Ther) Vol. 8 Issue 2 Pg. 255-8 (Apr 1994) ISSN: 0269-2813 [Print] England
• PMID: 8038357 (Publication Type: Journal Article)

Chemical References

• Blood Glucose
• Insulin
• Pyridines
• Triglycerides
• metapyrone
• prednisolone 21-3-sulfobenzoate
• Prednisolone
• Cortodoxone
• Hydrocortisone

Topics

• Administration, Rectal
• Adult
• Aged
• Blood Glucose
• Cortodoxone (blood)
• Enema
• Female
• Homeostasis (drug effects)
• Humans
• Hydrocortisone (blood)
• Hypothalamo-Hypophyseal System (drug effects)
• Insulin (blood)
• Intestinal Absorption
• Male
• Middle Aged
• Pituitary-Adrenal System (drug effects)
• Prednisolone (administration & dosage, analogs & derivatives, pharmacokinetics)
• Proctitis (drug therapy)
• Pyridines (pharmacology)
• Radioimmunoassay
• Triglycerides (blood)