Hyperbaric Oxygen Therapy for Ulcerative Colitis

Hyperbaric oxygen therapy (HBOT) markedly increases tissue oxygen delivery. Case series suggest it may have a potential therapeutic benefit in ulcerative colitis (UC). We investigated the therapeutic potential of HBOT as an adjunct to steroids for UC flares requiring hospitalization. Ulcerative colitis (UC) is a chronic inflammatory bowel disease which significantly affects the lives of nearly 1 million Americans. It is estimated that 25% of patients will need hospitalization for acute moderate to severe flares. Although colectomy is curative, it can be associated with significant morbidity, mortality and a reduction in quality of life. The mainstay of medical therapy for these patients is high dose intravenous steroids but approximately one-third of patients will be refractory and require second line rescue therapy with either cyclosporine or Infliximab, both of which are associated with a lack of significant efficacy in maintaining remission over the long term. Furthermore, corticosteroids have considerable long-term consequences and these immune suppressive drugs are associated with life-threatening infections and lymphomas. In an attempt to address this gap, we investigated the potential application of hyperbaric oxygen therapy (HBOT) as an adjunct to standard medical treatment. In a small phase 2A pilot study of 18 hospitalized UC patients, we were able to demonstrate a statistically significant increase in response, remission, and trend towards significance for avoidance of colectomy. We are now preparing for a phase 2B study in anticipation of a phase 3 registration trial and a multi-PI R01