Efficacy and safety of a novel high-dose mesalazine tablet in mild to moderate active ulcerative colitis: a double-blind, multicentre, randomised trial

Bacillus subtilis and Enterococcus faecium enteric-coated capsules combined with mesalazine for treatment of patients with ulcerative colitis: Efficacy and impact on serum levels of SOD, MDA, interleukins, and TNF-α

AIM

To observe the curative effect of Bacillus subtilis and Enterococcus faecium enteric-coated capsules and mesalazine in patients with ulcerative colitis and their impact on serum levels of interleukin (IL)-6, IL-8, IL-10, tumor necrosis factor α (TNF-α), malondialdehyde (MDA), superoxide dismutase (SOD), cyclooxygenase-2 (COX-2), and nuclear factor-κB (NF-κB).

METHODS

Eighty-six patients with ulcerative colitis admitted to our hospital from August 2014 to November 2016 were selected and randomly divided into an observation group and a control group, with 43 cases in each group. Both groups were given mesalazine enteric-coated tablets, and the observation group was additionally given Bacillus subtilis and Enterococcus faecium enteric-coated capsules. After continuous treatment for 2 mo, the clinical curative effect, time to symptom relief, Rachmitewitz score, and Sutherland score were recorded. Serum levels of IL-6, IL-8, IL-10, TNF-α, MDA, SOD), COX-2, and NF-κB were measured. The patients were followed for 6 mo to record the recurrence.

RESULTS

The total effective rate in the observation group was 93.02%, which was significantly higher than that in the control group (76.74%; Z = 4.440, P = 0.035). The time to relief of symptoms such as diarrhea, abdominal pain, and mucus and blood in stool was significantly shorter in the observation group than in the control group (P < 0.05). After treatment, Rachmitewitz and Sutherland scores of both groups decreased significantly compared with those before treatment, and the scores of the observation group were significantly lower than those of the control group (P < 0.05). After treatment, the levels of IL-6, IL-8, and TNF-α in the observation group were significantly lower and that of IL-10 was significantly higher in the observation group than in the control group (P < 0.05). Moreover, the levels of MDA, COX-2, and NF-κB were significantly lower and that of SOD was significantly higher in the observation group than in the control group (P < 0.05). During a follow-up period of 6 months, the recurrence rate was lower in the observation group than in the control group (11.63% vs 16.28%).

CONCLUSION

Bacillus subtilis and Enterococcus faecium enteric-coated capsules combined with mesalazine is better than mesalazine alone in reducing clinical symptoms and improving serum levels of inflammatory cytokines and oxidative stress in patients with ulcerative colitis, with no significant effect on long-term recurrence.