Hyperbaric oxygen therapy (HBOT) markedly increases tissue oxygen delivery and case series suggest it may have a potential therapeutic benefit in ulcerative colitis (UC).
The researchers conducted a study to evaluate dosing strategies with hyperbaric oxygen for hospitalised UC patients.
They have found that Hyperbaric oxygen therapy may be a useful and effective adjunct to steroids for UC flares requiring hospitalization. The research has been published in the Alimentary Pharmacology & Therapeutics Journal.
"The use of HBOT as adjunctive therapy to steroids for UC patients hospitalized for moderate-severe flares resulted in higher rates of clinical remission, and a reduction in rates of progression to second-line therapy during the hospitalization", says Parambir S Dulai, Head of Division of Gastroenterology, University of California San Diego, USA.
The study evaluated dosing strategies with hyperbaric oxygen for hospitalized UC patients with acute flares. 20 patients were treated with hyperbaric oxygen
"Initially, all patients received 3 days of hyperbaric oxygen at 2.4 atmospheres in addition to intravenous steroids. Day 3 responders were randomized to receive a total of 5 days vs 3 days of hyperbaric oxygen", explained Dulai.
Also, UC patients hospitalized for moderate-severe flares were blocked randomized to steroids + daily HBOT or steroids + daily sham hyperbaric air. The authors evaluated the primary outcome as the clinical remission rate at study day 5.
The study revealed the following findings-
a. Day 3 response was achieved in 55% (n = 11/20), with significant reductions in stool frequency, rectal bleeding and CRP.
b. A more significant reduction in disease activity was observed with 5 days vs 3 days of hyperbaric oxygen.
c. Day 3 hyperbaric oxygen responders were less likely to require re-hospitalization vs non‐responders.
d. No treatment‐related adverse events were observed.
Therefore, the researchers further concluded that "Hyperbaric oxygen appears to be effective for optimizing response to intravenous steroids in UC patients hospitalized for acute flares, with low rates of re-hospitalization or colectomy at 3 months". Also, an optimal clinical response is achieved with 5 days of hyperbaric oxygen. A larger phase 3 trials are needed to confirm the efficacy and obtain labeled approval.For further reference log on to: https://doi.org/10.1111/apt.15984
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