Once daily <i>vs</i> multiple daily mesalamine therapy for mild to moderate ulcerative colitis: a meta‐analysis

Li, W.; Zhang, Z.-M.; Jiang, Xue-Liang

doi:10.1111/codi.13393

Cited by 18 publications

(16 citation statements)

References 39 publications

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“…A similar study with once daily and three times daily dosing of mesalazine also showed no difference in incidence of adverse events . Several other studies have similarly demonstrated no difference in adverse events between once daily compared to divided dosing for mesalazine …”

Section: Resultsmentioning

confidence: 71%

Systematic review: safety of mesalazine in ulcerative colitis

Sehgal

Colombel

Aboubakr

et al. 2018

Aliment Pharmacol Ther

114

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Patients on mesalazine should be monitored for worsening of ulcerative colitis and development of new onset organ dysfunction. High-dose mesalazine appears to have similar safety profile as low dose, and is not associated with greater risk of adverse events. Prior to placing a patient on mesalazine, baseline liver and renal function should be evaluated. Renal function should be periodically assessed, whereas other testing should be performed depending on development of symptoms.

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Section: Resultsmentioning

confidence: 71%

Systematic review: safety of mesalazine in ulcerative colitis

Sehgal

Colombel

Aboubakr

et al. 2018

Aliment Pharmacol Ther

114

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“…The authors concluded that once-daily MSZ was effective in maintaining remission of UC for six months. Other authors have also observed that once-daily dose of mesalamine is as effective and safe as multiple daily doses for the induction and maintenance treatment of mild to moderate UC (8,9,19). Taking into account that once-daily dosing with 5-ASA is as effective as multiple doses it would be advisable to instruct patients to take a single daily dose to ease the treatment better than several administrations per day.…”

Section: Discussionmentioning

confidence: 99%

What is the real-life maintenance mesalazine dose in ulcerative colitis?

et al. 2016

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Objective: To describe how mesalazine (MSZ) is used in our practice in ulcerative colitis (UC), at what dose, and the success rate (regarding adherence to therapy).Methods: Observational, transversal study, including all patients with UC and with MSZ maintenance therapy seen from September 2014 to February 2015 at two IBD units in Spain. Treatment adherence was measured by the Morisky-Green scale.Results: We included 203 patients (mean MSZ dose: 2.6 ± 1.0 g/d; median of treatment: 19.5 months [IQR: 8-48]). Doses < 2 g/d were used in 15.3% of cases, 2-2.9 g/d doses in 35.0%, 3-3.9 doses in 29.5%, and ≥ 4 g/d doses in the remaining 20.2%. A single daily dose was preferred in 51.2% of cases, two doses in 33.0% and three doses in 15.8%. A different MSZ brand had been previously used in 36.6% of patients. In 134 cases (66%), the maintenance dose had been increased during a flare-up, and in 49 (36.6% of cases) this higher dose had been kept for maintenance (dose ≥ 4 g/d in 36 patients). During the MSZ therapy, 14 patients (6.9%) suffered mild side effects (21.4% altered liver function tests). Therapy adherence was good in 81.8% of cases.Conclusions: Half of our UC patients take high MSZ doses (≥ 3 g/d) as maintenance therapy, with acceptable safety and good adherence. Half of all patients take a single daily dose, and one third needed a different commercial brand during therapy. Opting for a higher MSZ maintenance dose is a possible strategy for a satisfactory maintenance therapy.

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“…Recently, a meta-analysis evaluated the efficacy, safety and adherence to once-daily and multiple-daily dosing of mesalamine for the induction and the maintenance of remission in mild-to-moderate UC. 40 With respect to adherence, no difference was noted between the two doses of 5-ASA.…”

Section: Introductionmentioning

confidence: 92%

Adherence in ulcerative colitis: an overview

Testa

Castiglione

Nardone

et al. 2017

PPA

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Medication adherence is an important challenge while treating chronic illnesses, such as ulcerative colitis (UC), that require a long-term management to induce and maintain clinical remission. This review provides an overview of the role that medication adherence plays in the routine management of UC, with a focus on the results of a recent Italian study reporting the perception of patients with UC regarding adherence to treatment. A literature analysis was conducted on topics, such as measurement of adherence in real practice, causes, risk factors and consequences of non-adherence and strategies, to raise patients’ adherence. Most of the data refer to adherence to 5-aminosalicylic acid, and standard of care for the induction and maintenance of remission in UC. The adherence rate to 5-aminosalicylic acid is low in clinical practice, thus resulting in fivefold higher risk of relapse, likely increased risk of colorectal cancer, reduced quality of life and higher health care costs for in- and outpatient settings. There are various causes affecting non-adherence to therapy: forgetfulness, high cost of drugs, lack of understanding of the drug regimen – which are sometimes due to insufficient explanation by the specialist – anxiety created by possible adverse events, lack of confidence in physicians’ judgment and complex dosing regimen. The last aspect negatively influences adherence to medication both in clinical trial settings and in real-world practice. Regarding this feature, mesalamine in once-daily dosage may be preferable to medications with multiple doses per day because the simplification of treatment regimens improves adherence.

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Once daily vs multiple daily mesalamine therapy for mild to moderate ulcerative colitis: a meta‐analysis

Abstract: OD dose of mesalamine is as effective and safe as MD doses for the induction and maintenance treatment of mild to moderate UC. OD mesalamine given as a suppository can attain the same effect and safety as MD mesalamine in inducing remission of mild to moderate ulcerative colitis.

Cited by 18 publications

References 39 publications

Systematic review: safety of mesalazine in ulcerative colitis

Systematic review: safety of mesalazine in ulcerative colitis

What is the real-life maintenance mesalazine dose in ulcerative colitis?

Adherence in ulcerative colitis: an overview

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