Role of Roflumilast in Ulcerative Colitis

Other illness

• Other inflammatory bowel disease (crohn's disease) .
• Patients with contraindications of colonoscopy e.g. suspected colonic perforation, acute peritonitis, pregnancy, severe bleeding tendency, shock, uncooperative patient and if toxic mega colon is suspected were excluded
• History of allergic reaction to Roflumilast or any component of the formulation Like rash , hives ,itching and redness .
• Moderate to severe hepatic impairment (child pugh class B or C) .

Age

• Patients \<15 and \>80 years

Other

• Patients who didn't give consent to participate in the study
• Depression , thoughts of suicide , anxiety and emotional instability .
• Excessive weight loss .
• Strong (CYP3A4) inducers : Barbiturates (phenobarbital) , Carbamazepine , Phenytoin , Rifampicin ( Risk , X interaction )
• Loxapine ( Risk , X interaction )

• Patients referred to endoscopy units in Tanta University hospitals during the period of the study.
  • Patient with mild to moderate UC diagnosed as:
• Clinical signs: Patients with moderate clinical disease have frequent loose, bloody stools (\>4per day), mild anemia, and abdominal pain that is not severe. Patients have minimal signs of systemic toxicity, including a low-grade fever. Adequate nutrition is usually maintained, and weight loss.
• Endoscopy : are necessary to establish the chronicity of inflammation and to exclude other causes of colitis.