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Budesonide Rectal Foam (BF) was introduced in 2017 and changed in November 2022 upon request, addressing the challenges encountered with liquid rectal formulations indicated for ulcerative colitis (UC). This formulation is an important agent in the treatment of rectal to sigmoid colon lesions in moderate UC. As the characteristics of the formulation of the rectal formulation are thought to influence patient satisfaction, a survey was conducted on the formulation and patient satisfaction among patients who used BF before and after the change. The survey spanned from January 2023 to May 2023. As the primary endpoint, the same patients were evaluated on the Visual Analogue Scale (VAS) for patient satisfaction. Significant variations in formulation usability and patient satisfaction were observed in 20 eligible patients before and after the change (p<0.05). Patient satisfaction with the formulation was strongly correlated with formulation usability, ease of pushing the head, and ease of insertion (r>0.7). The change in packaging was thought to improve the usability of the formulation and patient satisfaction. The formulation's usability and ease of insertion had a clear influence on satisfaction with the rectal formulation.

Inflammatory bowel disease (IBD) is an autoimmune disease that inflames the intestinal tract and reduces patient quality of life. In recent years, prescriptions of biologics and Janus kinase inhibitors have made outpatient pharmacists indispensable to clinics and hospitals. Therefore, we retrospectively investigated the effectiveness of immunopharmacist outpatient services in treating IBD. The survey spanned between January 2019 and December 2020 and included patients who had visited an IBD-specialized outpatient clinic. The endpoints were the number of pharmaceutical and accepted interventions, improvement rates, and cost-effectiveness of the pharmacist outpatient services. The definition of pharmaceutical intervention involves the pharmacist outpatient clinic, which refers to the number of prescription proposals made to doctors, and the dispensing room, which refers to the number of inquiries made to doctors. The survey included 139 patients, and 579 assessments were performed in the pharmacist outpatient clinic. Out of 352 pharmaceutical interventions by the outpatient pharmacist group, 341 (96.9%) were accepted by physicians. Similarly, out of 74 pharmaceutical interventions by the dispensing group, 54 (73.0%) were accepted by physicians (p<0.0001). The overall improvement rate of pharmaceutical interventions was 93.5%. The immunopharmacist outpatient clinic was found to be cost-effective, with an estimated value of 44068000 yen. In IBD outpatient services, clinical pharmacists and physicians are integral members of the medical care team and have a positive impact on drug treatment outcomes.

The urea breath test (UBT) is used widely for assessment of Helicobacter pylori (H. pylori) eradication after treatment. A false-negative UBT is common during administration of anti-ulcer drugs and immediately after their discontinuation. It was thought that the pharmaceutical care by the pharmacists was necessary for the diagnostic accuracy of UBT after H. pylori eradication therapy. Therefore, we investigated the effect of pharmaceutical care on diagnosis based on assessment of UBT. The patients who performed UBT were classified into two groups according to the pharmacists' intervention. From 2008 April to 2009 September, the number of the patients taken pharmaceutical care was 57 (intervention group) and that of the patients taken no pharmaceutical care was 62 (control group). When drugs for H. pylori infection and anamnestic therapy were same, the percentage that avoided administration of double drugs was significantly increased by the pharmaceutical care (93.3% in intervention group versus 21.4% in control group, p<0.05). Therefore, the percentage of noncompliance that performed UBT 4 weeks after treatment onward was significantly decreased by the pharmaceutical care (1.6% in intervention group versus 17.5% in control group, p<0.05). Moreover, the percentage of recurrence after treatment was significantly decreased, there were 3.3% in the intervention group and 14.0% in the control group. In conclusion, it was very important that the pharmacists take care in the management of treatment and UBT for H. pylori eradication therapy.

To clarify the functional recovery of the liver after partial hepatectomy, serum c-AMP responses to glucagon were investigated after hepatectomy in rats. Serum glucagon, insulin and weight of the regenerating liver were simultaneously measured. Wistar strain male rats, weighing 120-130 g, were divided into three groups; I 30% hepatectomy, II 70% hepatectomy and III sham operation. On the first postoperative day, cyclic AMP response to glucagon was remarkably decreased in I and II groups. In group I, c-AMP response returned to the normal level 2 weeks after operation. In group II the response returned to normal at the sixth postoperative week. The liver weights were almost normal after two weeks in the both groups. Levels of serum glucagon sharply increased 24 hours after operation and returned to the normal level after 7 days. However the levels of serum insulin showed no remarkable changes. In conclusion, the complete functional recovery of the liver after hepatectomy needed 6 weeks in cyclic AMP response to glucagon and was delayed 4 weeks to that of the liver weight after 70% hepatectomy. Insulin seems to have no direct effect of the liver regeneration.