Mo1783 Comparison of Rectal With Oral Mesalazine in the Treatment of Rectal Ulcerative Proctitis (CORRECT Study)

Kato, Shingo; Kani, Kazuhito; Kurihara, Hiroyuki; Ohmori, Toshihide; Yakabi, Koji

doi:10.1016/s0016-5085(16)32626-9

Cited by 2 publications

(8 citation statements)

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“…All trials, except four, were published in full. 37,68,70,76 Risk of bias for all included trials is reported in Supplementary Tables 5 and 6; only eight were at low risk of bias across all domains. 6,33,35,47,65,66,90,91 We provide data concerning histological remission and adverse events in the Supplementary Materials.…”

Section: Resultsmentioning

confidence: 99%

“…Forty RCTs reported data concerning efficacy of 5-ASAs in the induction of remission of active UC. 6,28,[30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][48][49][50][51][52][54][55][56][57][58][59][60][62][63][64][65][66][67][68][69][70] Thirteen RCTs recruited ≥50% of patients with left-sided colitis and extensive colitis, 6,39,42,52,55,57,58,62,63,64,…”

Section: Failure To Achieve Induction Of Remissionmentioning

confidence: 99%

“…There were 25 RCTs [31][32][33][34][35][36][39][40][41][43][44][45][48][49][50]54,[57][58][59][60]64,65,[67][68][69] reporting on induction of clinical remission following 5-ASA treatment. A total of 4559 patients were recruited in these studies, of whom 3696 were randomised to active treatment.…”

Section: Failure To Achieve Clinical Remissionmentioning

confidence: 99%

“…In a subgroup analysis, based on disease distribution, there were 11 RCTs, 34,39,40,49,[57][58][59]64,65,67,69 providing clinical remission data that recruited ≥50% of patients with left-sided colitis or extensive colitis, and 16 trials [31][32][33][34][35][36]41,[43][44][45]49,50,54,59,65,68 providing data that recruited ≥50% of patients with proctitis or proctosigmoiditis. When RCTs in left-sided colitis or extensive colitis were pooled there was borderline low heterogeneity (I 2 = 22.9%) and combined oral and topical mesalazine ranked first (RR = 0.31; 95% CI 0.12 to 0.82, P-score 0.97) (Supplementary Figure 5A), above high-dose and standard-dose oral mesalazine.…”

Section: Failure To Achieve Clinical Remissionmentioning

confidence: 99%

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Efficacy of Oral, Topical, or Combined Oral and Topical 5-Aminosalicylates, in Ulcerative Colitis: Systematic Review and Network Meta-analysis

Barberio

Segal

Quraishi

et al. 2021

Journal of Crohn's and Colitis

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Background 5-Aminosalicylates [5-ASAs] are the mainstay of treatment for ulcerative colitis [UC]. The optimum preparation, dose, and route of administration for UC remain unclear. We conducted a network meta-analysis to examine this issue. Methods We searched MEDLINE, EMBASE, EMBASE Classic, and the Cochrane central register of controlled trials from inception to December 2020. We included randomised controlled trials [RCTs] comparing oral, topical, or combined oral and topical 5-ASAs, with each other or placebo for induction of remission or prevention of relapse of UC. Results were reported as pooled relative risks [RRs] with 95% confidence intervals [CIs] to summarise effect of each comparison tested, with treatments ranked according to P-score. Results We identified 40 RCTs for induction of remission and 23 for prevention of relapse. Topical mesalazine [P-score 0.99], or oral and topical mesalazine combined [P-score 0.87] ranked first and second for clinical and endoscopic remission combined. Combined therapy ranked first in trials where ≥50% of patients had left-sided/extensive disease, and topical mesalazine first in trials where ≥50% of patients had proctitis/proctosigmoiditis. High-dose [≥3.3 g/day] oral mesalazine ranked third in most analyses, with the most trials and most patients. For relapse of disease activity, combined therapy and high-dose oral mesalazine ranked first and second, with topical mesalazine third. 5-ASAs were safe and well tolerated, regardless of regimen. Conclusions Our results support previous evidence; however, higher doses of oral mesalazine had more evidence for induction of remission than combined therapy and were significantly more efficacious than lower doses. Future RCTs should better establish the role of combined therapy for induction of remission, as well as optimal doses of oral 5-ASAs to prevent relapse.

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Section: Resultsmentioning

confidence: 99%

Section: Failure To Achieve Induction Of Remissionmentioning

confidence: 99%

Section: Failure To Achieve Clinical Remissionmentioning

confidence: 99%

Section: Failure To Achieve Clinical Remissionmentioning

confidence: 99%

See 2 more Smart Citations

Efficacy of Oral, Topical, or Combined Oral and Topical 5-Aminosalicylates, in Ulcerative Colitis: Systematic Review and Network Meta-analysis

Barberio

Segal

Quraishi

et al. 2021

Journal of Crohn's and Colitis

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“…Fifty manuscripts reporting on the results of 53 studies (4096 participants) met the inclusion criteria and were included in the review (Figure S1). 9,11,18–65 Several manuscripts report on the results of more than one study. Sandborn et al 9 report on the results of two phase III RCTs.…”

Section: Resultsmentioning

confidence: 99%

Systematic review with meta‐analysis: Medical therapies for treatment of ulcerative proctitis

Aruljothy,

Singh,

Narula

et al. 2023

Aliment Pharmacol Ther

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SummaryBackgroundUlcerative proctitis (UP) is a common highly symptomatic form of ulcerative colitis that can be difficult to treat.AimTo assess the efficacy of medical treatments for UP.MethodsWe searched MEDLINE, EMBASE, and CENTRAL on 23 November 2022 for randomised controlled trials (RCTs) of medical therapy for adults with UP. Primary outcomes included induction and maintenance of clinical remission. Pooled risk ratios (RRs) and 95% confidence intervals (CIs) were calculated for each outcome.ResultsWe included 53 RCTs (n = 4096) including 46 induction studies (n = 3731) and seven maintenance studies (n = 365). First‐line therapies included topical 5‐aminosalicylic acid (5‐ASA), conventional corticosteroids, budesonide, and oral 5‐ASA. Therapy for refractory UP included topical tacrolimus and small molecules. Topical 5‐ASA was superior to placebo for induction (RR 2.72, 95% CI 1.94–3.82) and maintenance of remission (RR 2.09, 95% CI 1.26–3.46). Topical corticosteroids were superior to placebo for induction of remission (RR 2.83, 95% CI 1.62–4.92). Topical budesonide was superior to placebo for induction of remission (RR 2.34, 95% CI 1.44–3.81). Combination therapy with topical 5‐ASA and topical corticosteroids was superior to topical monotherapy with either agent. Topical tacrolimus was superior to placebo. Etrasimod was superior to placebo for induction (RR 4.71, 95% CI 1.2–18.49) and maintenance of remission (RR 2.08, 95% CI 1.31–3.32).ConclusionsTopical 5‐ASA and corticosteroids are effective for active UP. Topical 5‐ASA may be effective for maintenance of remission. Tacrolimus may be effective for induction of remission. Etrasimod may be effective for induction and for maintenance of remission. Trials should include UP to expand the evidence base for this under‐represented population.

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Mo1783 Comparison of Rectal With Oral Mesalazine in the Treatment of Rectal Ulcerative Proctitis (CORRECT Study)

Cited by 2 publications

References 0 publications

Efficacy of Oral, Topical, or Combined Oral and Topical 5-Aminosalicylates, in Ulcerative Colitis: Systematic Review and Network Meta-analysis

Efficacy of Oral, Topical, or Combined Oral and Topical 5-Aminosalicylates, in Ulcerative Colitis: Systematic Review and Network Meta-analysis

Systematic review with meta‐analysis: Medical therapies for treatment of ulcerative proctitis

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