Transdermal Nicotine as a Treatment Option for Ulcerative Colitis: A Review.

Vishmita Kannichamy,Josh Alexander,Vinayak Mishra,Safeera Khan,Ifrah Kaleem,Ishan Antony,Mohamed Hisbulla,Amit Banerjee,Arohi B Gandhi

doi:10.7759/cureus.11096

Abstract

Ulcerative colitis (UC) is primarily a disease of non-smokers or ex-smokers. Since there have been previous claims of the beneficial effects of transdermal nicotine, researchers studied its efficacy to include it in the treatment regimen: to prevent remissions and as maintenance therapy. This review aims to evaluate the efficacy of transdermal nicotine as a treatment option for mild to moderately active ulcerative colitis. We shortlisted 22 articles after a careful analysis and elimination process. These articles were reviewed and analyzed, and it was found that transdermal nicotine in combination with conventional therapy was more beneficial than individual treatment with either. Further controlled studies evaluating the appropriate dosage for remission and maintenance treatment needs to be done.

Highlights

BackgroundUlcerative colitis is a non-transmural inflammatory disease of the colon with episodic flares and remissions along with abdominal pain, diarrhea, and rectal bleeding [1]
This review focuses on the efficacy of transdermal nicotine as a treatment option for ulcerative colitis
We identified a total of 308,273 patients for review, which included both patients with active ulcerative colitis and those with ulcerative colitis in remission

Summary

Introduction

BackgroundUlcerative colitis is a non-transmural inflammatory disease of the colon with episodic flares and remissions along with abdominal pain, diarrhea, and rectal bleeding [1]. The interrelationship between non-smoking and ulcerative colitis was identified and reported by Harries et al in 1982. He found that only 8% of the patients with the disease were smokers as compared with 44% of matched controls attending a fracture clinic [2]. Numerous case-control studies and meta-analysis have been conducted since establishing similar findings. This incidental finding has persuaded many to consider nicotine to be of therapeutic value given transdermally or by enema to treat ulcerative colitis [3]. Several clinical trials have examined the potency of nicotine in the form of enemas, transdermal patches, and chewing gum in the remissions of ulcerative colitis and have stated that nicotine was an effective treatment option

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