Randomised clinical trial: mesalazine (Salofalk granules) for uncomplicated diverticular disease of the colon – a placebo‐controlled study

Kruis, Wolfgang; Meier, Eberhard; Schumacher, M.; Mickisch, O; Greinwald, Roland; Müeller, Ralph

doi:10.1111/apt.12248

Cited by 88 publications

(52 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…CDD type 2c differentiates between purulent peritoni- Off-label treatment with mesalazine can be attempted [42]. However, changes in treatment recommendations can be expected in coming years.…”

Section: Acute Complicated Diverticulitismentioning

confidence: 99%

The CDD System in Computed Tomographic Diagnosis of Diverticular Disease

Pustelnik

Elsholtz

Bojarski

et al. 2017

Fortschr Röntgenstr

View full text Add to dashboard Cite

ABSTR AC TPurpose This overview sums up the Classification of Diverticular Disease (CDD) with regard to its application in computed tomographic diagnosis and briefly recapitulates its targeted advantages over preliminary systems. Primarily, application of the CDD in computed tomography diagnostics is described. Differences with respect to the categories of the older systems are pointed out on the level of each CDD type using imaging examples. Materials and MethodsThe presented images are derived from our institute according to the S2k criteria. Literature was researched on PubMed.Results The CDD constitutes an improvement compared to older systems for categorizing the stages of diverticular disease. It provides more discriminatory power on the descriptive-morphological level and defines as well as differentiates more courses of the disease. Furthermore, the categories translate more directly into state-of-the-art decisionmaking concerning hospitalization and therapy.Conclusion The CDD should be applied routinely in the computed tomographic diagnosis of diverticular disease. Typical imaging patterns are presented. Key points▪ The CDD is superior to its predecessors. It better stratifies Material und Methode Die gezeigten Bilder stammen aus der eigenen Klinik und wurden entsprechend der S2k-Leitlinie definiert. Ferner wurde eine PubMed-Literaturrecherche durchgeführt.Ergebnisse Die CDD stellt einen Fortschritt gegenüber älte-ren Klassifikationssystemen der Divertikelkrankheit dar. Sie bietet deskriptiv-morphologisch mehr Trennschärfe und erfasst und differenziert mehr Verläufe. Darüber hinaus über-setzen sich ihre Kategorien direkter in zeitgemäße Indikationsstellung von Hospitalisierung und Therapie. This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.Schlussfolgerung Die CDD sollte in der alltäglichen computertomografischen Befundung der Divertikelkrankheit verwendet werden. Hierzu wurden entsprechende Bildbeispiele hinterlegt.

show abstract

Section: Acute Complicated Diverticulitismentioning

confidence: 99%

The CDD System in Computed Tomographic Diagnosis of Diverticular Disease

Pustelnik

Elsholtz

Bojarski

et al. 2017

Fortschr Röntgenstr

View full text Add to dashboard Cite

show abstract

“…58 The use of mesalazine in patients with uncomplicated symptomatic diverticular disease has been proposed with a recent randomised trial reporting a nonsignificant reduction in median lower abdominal pain in the mesalazine group. 59 Reliable identification of patients with acute diverticulitis who may be safely treated in the community is required and further research is needed in this area to maximise the potential benefits of avoiding hospital admission for patients and to reduce health care costs.…”

Section: Risk Stratificationmentioning

confidence: 99%

“…There was no significant difference in recurrence, which was 32.1% on active vs. 25.6% on placebo. 59 The highest rates of acute diverticulitis were found in the placebo group of a randomised trial of 210 symptomatic uncomplicated diverticular disease patients randomised to four groups of mesalazine and/or probiotics and/or placebo. 70 Further studies are required using rigorous patient characterisation to further assess the role of antibiotics and 5-aminosalicylates, which also have antibacterial properties, in the prevention of recurrent attacks of acute diverticulitis.…”

Section: Conservative/medicalmentioning

confidence: 99%

Review article: the pathogenesis and management of acute colonic diverticulitis

Humes

Spiller

2014

Aliment Pharmacol Ther

View full text Add to dashboard Cite

SummaryBackgroundAcute diverticulitis, defined as acute inflammation associated with a colonic diverticulum, is a common emergency presentation managed by both surgeons and physicians. There have been advances in both the medical and the surgical treatments offered to patients in recent years.AimTo review the current understanding of the aetiology and treatment of acute diverticulitis.MethodsA search of PubMed and Medline databases was performed to identify articles relevant to the aetiology, pathogenesis and management of acute diverticulitis.ResultsThere are 75 hospital admissions per year for acute diverticulitis per 100 000 of the population in the United States. Recent reports suggest a 26% increase in admissions over a 7‐year period. Factors predisposing to the development of acute diverticulitis include obesity, smoking, diet, lack of physical activity and medication use such as aspirin and nonsteroidal anti‐inflammatory drugs. The condition is associated with a low mortality of about 1% following medical therapy, rising to 4% in‐hospital mortality in those requiring surgery. There is limited evidence on the efficacy of individual antibiotic regimens, and antibiotic treatment may not be required in all patients. The rates of recurrence reported for patients with acute diverticulitis following medical management vary from 13% to 36%. The surgical management of those patients who fail medical treatment has moved towards a laparoscopic nonresectional approach; however, the evidence supporting this is limited.ConclusionsFurther high‐quality randomised controlled trials are required of both medical and surgical treatments in patients with acute diverticulitis, if management is to be evidence‐based.

show abstract

“…Nasilenie objawów podmiotowych pod koniec obserwacji zmniejszyło się istotnie w grupie A w porównaniu z grupą B. W czasie obserwacji nawrót objawowego zapalenia uchyłków stwierdzono u 3 chorych z grupy A i u 13 cho rych z grupy B (p < 0,005). W badaniu wykazano, że ryfaksymina w skojarzeniu z mesalazyną jest skuteczniejsza niż stosowana w mo noterapii w zmniejszaniu nasilenia objawów podmio towych i zapobieganiu nawrotom zapalenia uchyłków [11].…”

Section: Mesalazyna W Leczeniu Choroby Uchyłkowejunclassified

“…W wieloośrodkowym badaniu klinicznym prze prowadzonym metodą podwójnie ślepej próby i kontrolowanym placebo, trwającym 6 tygodni pacjenci byli randomizowani do grupy otrzymującej mesalazynę w dawce 1000 mg 3 razy dziennie lub placebo. Dawka 3 g mesalazyny dziennie zmniejszała bóle w dolnej części brzucha towarzyszące objawowej, niepowikłanej chorobie uchyłkowej, w związku z czym wydaje się, że mesalazyna stanowi obiecującą opcję terapeutyczną [11].…”

Section: Mesalazyna W Leczeniu Choroby Uchyłkowejunclassified