Role of Roflumilast in Ulcerative Colitis

Inclusion Criteria: 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. Exclusion Criteria: Other inflammatory bowel disease (crohn's disease) . Patients <15 and >80 years Patients who didn't give consent to participate in the study 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 . Depression , thoughts of suicide , anxiety and emotional instability . Excessive weight loss . Moderate to severe hepatic impairment (child pugh class B or C) . Strong (CYP3A4) inducers : Barbiturates (phenobarbital) , Carbamazepine , Phenytoin , Rifampicin ( Risk , X interaction ) Loxapine ( Risk , X interaction )