Combined treatment with corticotropin(ACTH) and glucocorticoid for severe attacks of ulcerative colitis.

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A study was performed to investigate combined treatment with Corticotropin (ACTH) and glucocorticoid for severe attacks of ulcerative colitis unresponsive to glucororticoid therapy including the intensive intravenous regimen. The series included three men and four wowen, with an average age of 23 yr. Before administration of ACTH, prednisolone was given at a dosage of 30-60 mg daily (except for a 10-year-old girl, who was given a dosage of 20 mg) for 3-26 days, and total parenteral nutrition was used for four patients. However these treatments were ineffective. ACTH, at 20 units every 12 hours, was intramuscularly given (except for the 10-year-old girl, who received 10 units). Five patients achieved remission with the combined therapy after a mean period of 5.6 days. One patient showing clinical improvement without remission and one showing no change required urgent surgery. Combined treatment with ACTH and glucocorticoid is therefore considered to be effective for severe attacks of ulcerative colitis that are resistant to glucocorticoid therapy.
日本大腸肛門病学会の論文