Comparative, open, randomized trial of the efficacy and tolerance of slow-release 5-ASA suppositories once daily versus conventional 5-ASA suppositories twice daily in the treatment of active cryptogenic proctitis: French Pentasa Study Group

OBJECTIVE

The efficacy and tolerance of slow-release 5-ASA suppositories (Pentasa 1 g/day) were compared with those of conventional 5-ASA suppositories (Rowasa 0.5 g b.i.d.).

METHODS

Two hundred and fifty-one (251) patients presenting with an exacerbation of cryptogenic proctitis were randomized. Clinical activity and rectal lesions were measured at days 1 and 14 (and at day 21 for patients not in remission at day 14), and each patient had to fill out a daily diary card (checklist).

RESULTS

Results are given for slow-release and classical suppositories, respectively. The reduction in symptoms and lesions was identical in both groups. Treatment was continued until day 21 in 36% versus 33% of the patients, and minor or moderate side effects occurred in 5.6% versus 6.3% (NS). The tolerance of the suppositories was rated as satisfactory every day by 77% versus 54% (p = 0.001), and early suppository expulsion occurred in 0.5% versus 3.4% (p = 0.001).

CONCLUSIONS

The treatments were equally effective and both were well tolerated. However, the advantages of the slow-release suppositories were that patients exhibited greater tolerance and early expulsion was less frequent.

[Oxyurid granuloma of the mesentery]

A 44-year-old woman presented with an acute abdominal syndrome associated with fever. Laparotomy revealed a mesenteric mass; pathology demonstrated a granuloma containing an adult threadworm (Enterobius vermicularis) and its eggs. Ectopic oxyuriasis is rare, and only three cases of peritoneal granuloma distant from the pelvis or the appendix have been reported previously. Our observation is the first case to which a clinical symptomatology could be ascribed. The pathogenesis and the treatment of this particular localization of oxyuriasis are discussed.