Oral 5-aminosalicylic acid for induction of remission in ulcerative colitis

Murray, Alistair; Nguyen, Tran M; Parker, Claire E; Feagan, Brian G.; MacDonald, John K

doi:10.1002/14651858.cd000543.pub5

Cited by 37 publications

(64 citation statements)

References 134 publications

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“…The optimal dose of oral 5-ASA treatment has been debated for many years. Meta-analyses of RCTs suggest a threshold for treatment effect at a minimum dose of 2.0 g/day for induction of remission or response, 2 and patients with moderately active UC may benefit from 4.8 g/day rather than 2.4 g/day. 1 , 20 – 22 Dosing of oral 5-ASA once or twice daily does not seem to affect clinical efficacy.…”

Section: Introductionmentioning

confidence: 99%

“…Introduction 5-Aminosalicylic acid (5-ASA) is the first-line therapy for patients with ulcerative colitis (UC) and is effective both for inducing and maintaining remission. 1,2 5-ASA is proposed to act through numerous mechanisms, including inhibition of pro-inflammatory mediators and peroxisome proliferator-activated receptor gamma (PPAR-γ) receptor agonism, 3 as well as altering the intestinal microbiota. 4 Drug persistence has emerged as a relevant parameter reflecting the long-term therapeutic performance of anti-inflammatory drugs in a reallife setting.…”

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confidence: 99%

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Factors associated with the persistence of oral 5-aminosalicylic acid monotherapy in ulcerative colitis: a nationwide Norwegian cohort study

Fossmark

Olaisen

Martinsen

et al. 2021

Therap Adv Gastroenterol

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Background: Oral 5-aminosalicylic acid (5-ASA) is the mainstay treatment of ulcerative colitis (UC) and therapy with oral 5-ASA is associated with beneficial outcomes. We have examined factors associated with the persistence of oral 5-ASA treatment in a national cohort of UC patients. Methods: Patients with newly diagnosed UC from 2010 to 2014 using oral 5-ASA monotherapy were identified by combining data from the Norwegian Patient Registry and the Norwegian Prescription Database. The median follow-up time was 1029 days. Drug persistence was defined as duration of oral 5-ASA preparation as monotherapy. Non-persistence of a oral 5-ASA preparation as monotherapy was defined as stopping oral 5-ASA, initiation of any further anti-inflammatory treatment including a course of glucocorticoids and a change to another oral 5-ASA preparation. Drug persistence was analyzed using the Kaplan–Meier method and influence of covariates on drug persistence was analyzed with the Cox proportional hazard model. Results: A total of 3421 patients were identified. The overall median 5-ASA drug persistence was 179 days. In univariate analyses, persistence was associated with preparation type and high-dose treatment, while oral glucocorticoid use or hospitalization around the start of oral 5-ASA were associated with shorter 5-ASA persistence. In multivariate analyses, oral glucocorticoids [HR 1.67 (1.54–1.80), p < 0.005] and hospitalization around start of 5-ASA [HR 1.23 (1.14–1.34), p < 0.005] were associated with non-persistence, whereas high dose (⩾3 g/day) 5-ASA was associated with longer persistence [HR 0.68 (0.65–0.71), p < 0.005]. Conclusion: High-dose treatment with oral 5-ASA was associated with longer persistence of oral 5-ASA monotherapy, whereas the presence of factors indicating more severe disease around initiation of 5-ASA monotherapy was associated with a shorter persistence.

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Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

Factors associated with the persistence of oral 5-aminosalicylic acid monotherapy in ulcerative colitis: a nationwide Norwegian cohort study

Fossmark

Olaisen

Martinsen

et al. 2021

Therap Adv Gastroenterol

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“…The 5‐aminosalicylates (5‐ASA) are the most commonly prescribed medications to induce and maintain remission for mild to moderate UC patients in elderly 22–24 . In a population‐based study, 72% of the older‐onset UC patients were treated with 5‐ASAs 14 .…”

Section: Medical Therapy Of Elderly Ulcerative Colitismentioning

confidence: 99%

“…The 5‐aminosalicylates (5‐ASA) are the most commonly prescribed medications to induce and maintain remission for mild to moderate UC patients in elderly. 22 , 23 , 24 In a population‐based study, 72% of the older‐onset UC patients were treated with 5‐ASAs. 14 In the French prospective population‐based cohort (EPIMAD) study, the cumulative probability of receiving 5‐ASA therapy for older‐onset UC patients was 75%.…”

Section: Medical Therapy Of Elderly Ulcerative Colitismentioning

confidence: 99%

Clinical characteristics of ulcerative colitis in elderly patients

Zhu

Ran

2021

JGH Open

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The incidence of ulcerative colitis (UC) in elderly patients is increasing. Elderly UC patients are likely to exhibit distinct features both at diagnosis and during follow‐up. Age‐related problems, including complications, immune dysfunction, and multidrug use, make the diagnosis and treatment of elderly UC more challenging. Suboptimal treatment considering adverse events leads to poor clinical outcome in elderly UC patients. Here, we reviewed the epidemiology, clinical presentation, medical therapy, colorectal cancer surveillance of UC in elderly patients.

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“…NAFLD is also frequently reported in patients with IBD 63,70,71 . Mesalamine, a PPAR agonist, has been documented to have beneficial effects in active, mild to moderate UC [72][73][74] . It has also been used successfully in maintenance therapy for UC 75 .…”

Section: Introductionsmentioning

confidence: 99%

Assessment of mesalamine in the alterations of metabolic parameters in comorbid ulcerative colitis and metabolic syndrome patients: A retrospective study

et al. 2021

Preprint

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BACKGROUND & AIMS: It is unclear how the gut targeting medication mesalamine alters metabolic parameters associated with Metabolic Syndrome (MetS). We completed a retrospective analysis on ulcerative colitis (UC) and MetS comorbid patients receiving mesalamine to examine the effects of mesalamine on the metabolic risk factors associated with MetS. METHODS: We performed a retrospective chart review using Cerner Health Facts (from July 2007 to July 2017). We identified UC patients with a MetS comorbidity and who were prescribed mesalamine within +/- 7 days of an encounter in which they were diagnosed with UC. We then collected the patients blood pressure, labs, and body measurement index (BMI) for each of these patient at the index date and the closest values to 12 months after the index date. We used analysis of covariance (ANCOVA) to determine the effect of mesalamine therapy in patients with both UC and MetS on the metabolic parameters after 12 months of treatment compared to baseline. RESULTS: Our search of Cerner Health Facts identified 6,197 UC patients with concomitant MetS who were prescribed mesalamine. Of these individuals, 48% were female and 52% were male and within this cohort 88.3% received oral mesalamine and 11.7% received mesalamine via the rectal route. Oral mesalamine reduced fasting glucose levels and increased HDL cholesterol in these patients. C-reactive protein levels and erythrocyte sedimentation rate were also significantly reduced. Rectal mesalamine only reduced BMI. Further analysis revealed several MetS conditions risk factors were further improved when mesalamine was taken in the absence of medication for hypertension, hyperglycemia or dyslipidemia. CONCLUSION: In a retrospective chart study of UC-MetS patients, we found oral mesalamine improved several metabolic parameters associated with MetS. Our findings suggest the PPAR agonist mesalamine that targets the gastrointestinal tract could prove beneficial in improving hypertension, hyperglycemia and dyslipidemia.

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Oral 5-aminosalicylic acid for induction of remission in ulcerative colitis

Cited by 37 publications

References 134 publications

Factors associated with the persistence of oral 5-aminosalicylic acid monotherapy in ulcerative colitis: a nationwide Norwegian cohort study

Factors associated with the persistence of oral 5-aminosalicylic acid monotherapy in ulcerative colitis: a nationwide Norwegian cohort study

Clinical characteristics of ulcerative colitis in elderly patients

Assessment of mesalamine in the alterations of metabolic parameters in comorbid ulcerative colitis and metabolic syndrome patients: A retrospective study

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