Ulcerative Colitis: Taminiau J

Wiersma H, Escher JC, Dilger K, Trenk D, Benninga MA, van Boxtel CJ, Taminiau J. · Department of Clinical Pharmacology and Pharmacotherapy, Academic Medical Center, Amsterdam, The Netherlands. · Inflamm Bowel Dis. · Pubmed #15472525 No free full text.

Abstract: Mesalazine is a first-line drug in pediatric inflammatory bowel disease (IBD), and is customarily used to induce and maintain remission in mild to moderate disease. In children, pharmacokinetic data are scarce, and dosage recommendations are largely extrapolated from studies in adults. Aim of the study was to obtain the pharmacokinetic profile of a new mesalazine pellet formulation in children with ulcerative colitis and Crohn's colitis. A single oral dose of 20 mg/kg mesalazine was administered to 13 patients (age 6-16 years). Serial blood and urine sampling for determination of mesalazine and acetylmesalazine was performed before and during 24 hours following ingestion. Maximum plasma concentration of mesalazine (Cmax) was 1332 ng/mL (geometric mean, geometric coefficient of variation [CV]: 0.57), obtained 3.7 hours (tmax; CV: 0.31) after drug administration. Systemic exposure as determined by area under the plasma concentration-time curve (AUC(0-infinity) ) was 8712 ng/ml*h (CV: 0.44). Terminal half-life of elimination of mesalazine was 3.5 hours (t(1/2); CV: 1.43). This study presents extensive pharmacokinetic data on mesalazine in children with mild-moderately active ulcerative colitis and Crohn's colitis. In comparison with previous experience in adults, pharmacokinetics of mesalazine administered as pellets appear to be similar in both populations.

Escher JC, ten KF, Lichtenbelt K, Schornagel I, Büller H, Derkx B, Taminiau J. · Department of Pediatric Gastroenterology, Emma Children's Hospital, University of Amsterdam, The Netherlands. · Inflamm Bowel Dis. · Pubmed #11837934 No free full text.

Abstract: BACKGROUND: In children with inflammatory bowel disease (IBD), treatment depends on the type and extent of disease. Therefore, maximal effort should be made to provide a correct diagnosis. The aim of this study was to assess the value of a histologic diagnosis made on the basis of either ileal and colonic or rectosigmoid biopsies. METHODS: In 42 children with a known diagnosis of IBD, biopsies from rectum and sigmoid were reassessed by an expert, blinded pathologist. This histologic diagnosis was compared with the diagnosis based on (ileo)colonic biopsies and the final diagnosis. RESULTS: In patients with IBD, diagnostic accuracy of rectosigmoid histology was 0.4524. For (ileo)colonic biopsies, diagnostic accuracy was 0.7619. CONCLUSIONS: Histology on biopsies from rectum and sigmoid is insufficient for a correct diagnosis of Crohn's disease or ulcerative colitis in children. At initial presentation, an ileocolonoscopy with biopsies should therefore be performed in all children.