The goal of this study is to evaluate the safety and efficacy of Small intestinal release mesalamine (SIRM) for symptom relief in refractory celiac disease (RCD).
Therapeutic options for the RCD are inadequate and treatment with corticosteroids and immunosuppressants is limited by side effects. SIRM has been shown to have local antiinflammatory action and excellent tolerability.
We reviewed records of the RCD patients who received SIRM in an open-label therapeutic trial. Data included demographics, disease characteristics, dose and duration of SIRM therapy, and response. Response was categorized as complete if there was complete resolution of symptoms, partial if there was at least 50% improvement, and nonresponsive if there was less than 50% improvement.
Four patients were treated with SIRM alone and 6 received SIRM and oral budesonide. Within 4 weeks, 50% had complete response and an additional 10% had partial response. Two of the 6 patients were able to discontinue budesonide. One patient discontinued SIRM owing to headaches.
SIRM seems to be a safe and efficacious treatment option in patients with RCD. Larger, controlled trials of this agent are warranted.
*Celiac Center, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
Financial Statement: All funding was provided by the Celiac Center at Beth Israel Deaconess Medical Center.
Conflict of Interest Statements: No conflicts of interest exist.
All authors were involved in study design, patient recruitment, data analysis, and manuscript preparation.
Reprints: Shailaja Jamma, MD, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA 02215, (e-mail: firstname.lastname@example.org).
Received March 4, 2010
Accepted July 23, 2010