New Delhi. Nicotine therapy may be of benefit to a limited number of patients with refractory ulcerative colitis said Dr KK Aggarwal, President Heart Care Foundation of India. Several epidemiologic studies have suggested a protective effect of nicotine on ulcerative colitis disease activity.

Two placebo controlled trials, published in the New England Journal of Medicine and Annals of Internal Medicine, of transdermal nicotine in active mild ulcerative colitis showed a beneficial effect of nicotine therapy. The first study, evaluated 72 patients, all of whom were treated with mesalamine and 12 of whom received corticosteroids. Treatment with a nicotine patch (15 to 25 mg per 24 hours) led to complete remission in 17 of 35 patients versus only 9 of 37 given placebo. Side effects were considerable in those patients who were nonsmokers.

Transdermal nicotine is not effective for maintaining remission in ulcerative colitis. Thus, it may be used to bring patients into remission who will then require additional forms of maintenance therapy.

Ulcerative colitis is an inflammatory bowel disease of uncertain etiology that is characterized by recurring episodes of inflammation primarily involving the mucosal layer and occasionally the submucosa of the colon.