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Patients with refractory Crohn's disease or ulcerative colitis
respond to dehydroepiandrosterone: a pilot study.

Andus T, Klebl F, Rogler G, Bregenzer N, Scholmerich J, Straub RH.

Department of Internal Medicine I, University of Regensburg,
Regensburg, Germany. TAndus@...

BACKGROUND: Dehydroepiandrosterone is a steroid hormone used as
an 'over-the-counter' drug in the USA. Treatment with
dehydroepiandrosterone was effective in randomized controlled trials
in patients with systemic lupus erythematosus. Dehydroepiandrosterone
sulphate concentrations are decreased in patients with inflammatory
bowel disease. Dehydroepiandrosterone inhibits nuclear factor-kappaB
and the secretion of interleukin-6 and interleukin-12 via the
peroxisome proliferator-activated receptor alpha. AIM: A phase II
pilot trial was started to evaluate the effect of
dehydroepiandrosterone in active inflammatory bowel disease. METHODS:
Twenty patients with chronic active inflammatory bowel disease [seven
Crohn's disease (Crohn's disease activity index, 242 +/- 51; mean +/-
s.d.); 13 ulcerative colitis (clinical activity index, 7.8 +/- 2.1)]
took 200 mg dehydroepiandrosterone per day orally for 56 days.
RESULTS: Six of the seven patients with Crohn's disease and eight of
the 13 patients with ulcerative colitis responded to treatment, with
a decrease in the Crohn's disease activity index of > 70 points and a
decrease in the clinical activity index of > 4 points, respectively.
Six Crohn's disease patients and six ulcerative colitis patients went
into remission (Crohn's disease activity index < 150; clinical
activity index <or= 4). No patient withdrew from the study because of
side-effects. CONCLUSIONS: In a pilot study, dehydroepiandrosterone
was effective and safe in patients with refractory Crohn's disease or
ulcerative colitis. Adjustment of the dehydroepiandrosterone dosage
may further improve the treatment success.

Publication Types:
Clinical Trial
Clinical Trial, Phase II

PMID: 12562454 [PubMed - indexed for MEDLINE]