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Cited by 505Inflammatory Bowel DiseaseSmoking Behavior and CessationMicroscopic Colitis

The DOI matches its Crossref record; 28 of the 28 references it cites were found in a registry or an index.

Transdermal Nicotine for Active Ulcerative Colitis

Pullan, Rupert D., Rhodes, John, Ganesh, Subramanian, Mani, Venk, Morris, John S., Williams, Geraint T., Newcombe, Robert G., Russell, Michael, Feyerabend, Colin, Thomas, Gareth, Sawe, Urbain·1994·New England Journal of Medicine
DOI 10.1056/nejm199403243301202
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Abstract

BACKGROUND: Ulcerative colitis is largely a disease of nonsmokers. Because anecdotal reports suggest that smoking and nicotine may improve the symptoms of the disease, we examined the effect of nicotine as a supplemental treatment for ulcerative colitis. METHODS: We treated 72 patients with active ulcerative colitis with either transdermal nicotine patches or placebo patches for six weeks in a randomized, double-blind study. Incremental doses of nicotine were given; most patients tolerated doses of 15 to 25 mg per 24 hours. All the patients had been taking mesalamine, and 12 were receiving low doses of glucocorticoids; these medications were continued without change during the study. Clinical, sigmoidoscopic, and histologic assessments were made at base line and at the end of the study; symptoms were recorded daily on a diary card, and the clinician made a global assessment. Side effects and plasma nicotine and cotinine concentrations were monitored throughout the study. RESULTS: Seventeen of the 35 patients in the nicotine group had complete remissions, as compared with 9 of the 37 patients in the placebo group (P = 0.03). The patients in the nicotine group had greater improvement in the global clinical grade of colitis (P < 0.001) and the histologic grade (P = 0.03), lower stool frequency (a difference of 1.6 stools daily; P = 0.008), less abdominal pain (P = 0.05), and less fecal urgency (P = 0.009). More patients in the nicotine group had side effects (23, vs. 11 in the placebo group; P = 0.002), the most common of which were nausea, lightheadedness, headache, and sleep disturbance. Withdrawals due to ineffective therapy were more common in the placebo group (3 vs. 8, P = 0.12). CONCLUSIONS: The addition of transdermal nicotine to conventional maintenance therapy improves symptoms in patients with ulcerative colitis.

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Crossref · 10.1056/nejm199403243301202

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Citations

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Show all 28 references

Research works printed but not linked: 6

  1. Roberts CJ, 1982, BMJ, 285, 440
  2. Srivastava ED, 1991, Eur J Gastroenterol, 3, 815
  3. Allen A, Bell A, McQueen S. Mucus and mucosal protection. In: Allen A, Flemstrom G, Garner A, Silen W, Turnberg LA, eds. Mechanisms of mucosal protection in the upper gastrointestinal tract. New York: Raven Press, 1984:195-201.
  4. Cope GF, 1986, Gut, 27, A618
  5. Dubois JP, 1989, Methods Find Exp Clin Pharmacol, 11, 187
  6. Russell MAH. Nicotine intake and its control over smoking. In: Wonnacott S, Russell MAH, Stolerman IP, eds. Nicotine psychopharmacology: molecular, cellular, and behavioural aspects. Oxford, England: Oxford University Press, 1990:374-418.

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Metadata

Authors
Pullan, R. D., Rhodes, J., Ganesh, S., Mani, V., Morris, J. S., Williams, G. T., Newcombe, R. G., Russell, M., Feyerabend, C., Thomas, G., & Sawe, U.
Affiliations
  • University Hospital of Wales (GB)
  • University of Wales (GB)
  • Princess of Wales Hospital (GB)
  • New Cross Hospital (GB)
ORCID
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
1994-03-24
Volume
330
Issue
12
Pages
811-815
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejm199403243301202
OpenAlex
W2315418290
Cited by
505
References
28
Citations by year
2026: 3 · 2025: 6 · 2024: 9 · 2023: 11 · 2022: 10 · 2021: 10 · 2020: 20 · 2019: 9 · 2018: 14 · 2017: 7 · 2016: 5 · 2015: 11 · 2014: 14 · 2013: 15 · 2012: 9
FWCI
15.58
Type
journal article
Language
en
Open access
closed
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Gastroenterology › Inflammatory Bowel Disease
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
  • Health Sciences › Medicine › Gastroenterology › Microscopic Colitis
Keywords
ulcerative colitis, transdermal nicotine, nicotine patch, smoking, nicotine withdrawal, 5-aminosalicylic acid, maintenance therapy, remission, symptom improvement, adverse effects
MeSH terms
Administration, Cutaneous, Adult, Affect, Colitis, Ulcerative, Cotinine, Double-Blind Method, Female, Humans, Male, Middle Aged, Nicotine, Treatment Outcome, Drug Monitoring

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