The risk factor of clinical relapse in ulcerative colitis patients with low dose 5-aminosalicylic acid as maintenance therapy

A report from the IBD registry

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6 Citations (Scopus)

Abstract

Background: 5-Aminosalicylic acids (5-ASA) are effective for ulcerative colitis (UC) as a maintenance therapy. It is not clear when and how to reduce a dose of 5-ASA after inducing remission. We aimed to investigate the clinical characteristics and evaluate the risk factors of relapse for UC patients receiving 5-ASA. Methods: The medical records of prospectively registered UC patients who received oral 5-ASA as maintenance therapy between January and December 31, 2014, were investigated. The patients’ clinical characteristics in a 2-year follow-up were compared between a relapse group and a remission group. Results: Of 527 UC patients receiving only oral 5-ASA, 390 (74.0%) maintained remission and 137 (26.0%) relapsed during the follow-up period. Multivariable analysis indicated that a shorter duration of disease remission (p < 0.001, OR: 1.24, 95% CI: 1.12–1.38) was statistically significant for each comparison between the remission and relapse groups among all the patients. Risk factors for clinical relapse were a shorter duration of disease remission (p <0.001, OR: 1.17, 95% CI: 1.04–1.33) in the high-dose 5-ASA group and a shorter duration of disease remission (p = 0.003, OR: 1.45, 95% CI: 1.13–1.89) and a history of steroid use (p = 0.048, OR: 4.73, 95% CI: 1.01–22.2) in the low-dose group. Conclusions: A dose reduction of 5-ASA might be cautiously selected in UC patients with a history of steroid use and a shorter duration of disease remission.

Original languageEnglish
Article numbere0187737
JournalPLoS One
Volume12
Issue number11
DOIs
Publication statusPublished - 2017 Nov 1

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Mesalamine
colitis
relapse
remission
Ulcerative Colitis
Registries
risk factors
Recurrence
therapeutics
acids
dosage
duration
Therapeutics
steroids
Steroids
mouth
Medical Records

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

@article{c116f471c55a4d2aacca62aebb494a76,
title = "The risk factor of clinical relapse in ulcerative colitis patients with low dose 5-aminosalicylic acid as maintenance therapy: A report from the IBD registry",
abstract = "Background: 5-Aminosalicylic acids (5-ASA) are effective for ulcerative colitis (UC) as a maintenance therapy. It is not clear when and how to reduce a dose of 5-ASA after inducing remission. We aimed to investigate the clinical characteristics and evaluate the risk factors of relapse for UC patients receiving 5-ASA. Methods: The medical records of prospectively registered UC patients who received oral 5-ASA as maintenance therapy between January and December 31, 2014, were investigated. The patients’ clinical characteristics in a 2-year follow-up were compared between a relapse group and a remission group. Results: Of 527 UC patients receiving only oral 5-ASA, 390 (74.0{\%}) maintained remission and 137 (26.0{\%}) relapsed during the follow-up period. Multivariable analysis indicated that a shorter duration of disease remission (p < 0.001, OR: 1.24, 95{\%} CI: 1.12–1.38) was statistically significant for each comparison between the remission and relapse groups among all the patients. Risk factors for clinical relapse were a shorter duration of disease remission (p <0.001, OR: 1.17, 95{\%} CI: 1.04–1.33) in the high-dose 5-ASA group and a shorter duration of disease remission (p = 0.003, OR: 1.45, 95{\%} CI: 1.13–1.89) and a history of steroid use (p = 0.048, OR: 4.73, 95{\%} CI: 1.01–22.2) in the low-dose group. Conclusions: A dose reduction of 5-ASA might be cautiously selected in UC patients with a history of steroid use and a shorter duration of disease remission.",
author = "Tomohiro Fukuda and Makoto Naganuma and Shinya Sugimoto and Kosaku Nanki and Shinta Mizuno and Makoto Mutaguchi and Yoshihiro Nakazato and Nagamu Inoue and Haruhiko Ogata and Yasushi Iwao and Takanori Kanai",
year = "2017",
month = "11",
day = "1",
doi = "10.1371/journal.pone.0187737",
language = "English",
volume = "12",
journal = "PLoS One",
issn = "1932-6203",
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TY - JOUR

T1 - The risk factor of clinical relapse in ulcerative colitis patients with low dose 5-aminosalicylic acid as maintenance therapy

T2 - A report from the IBD registry

AU - Fukuda, Tomohiro

AU - Naganuma, Makoto

AU - Sugimoto, Shinya

AU - Nanki, Kosaku

AU - Mizuno, Shinta

AU - Mutaguchi, Makoto

AU - Nakazato, Yoshihiro

AU - Inoue, Nagamu

AU - Ogata, Haruhiko

AU - Iwao, Yasushi

AU - Kanai, Takanori

PY - 2017/11/1

Y1 - 2017/11/1

N2 - Background: 5-Aminosalicylic acids (5-ASA) are effective for ulcerative colitis (UC) as a maintenance therapy. It is not clear when and how to reduce a dose of 5-ASA after inducing remission. We aimed to investigate the clinical characteristics and evaluate the risk factors of relapse for UC patients receiving 5-ASA. Methods: The medical records of prospectively registered UC patients who received oral 5-ASA as maintenance therapy between January and December 31, 2014, were investigated. The patients’ clinical characteristics in a 2-year follow-up were compared between a relapse group and a remission group. Results: Of 527 UC patients receiving only oral 5-ASA, 390 (74.0%) maintained remission and 137 (26.0%) relapsed during the follow-up period. Multivariable analysis indicated that a shorter duration of disease remission (p < 0.001, OR: 1.24, 95% CI: 1.12–1.38) was statistically significant for each comparison between the remission and relapse groups among all the patients. Risk factors for clinical relapse were a shorter duration of disease remission (p <0.001, OR: 1.17, 95% CI: 1.04–1.33) in the high-dose 5-ASA group and a shorter duration of disease remission (p = 0.003, OR: 1.45, 95% CI: 1.13–1.89) and a history of steroid use (p = 0.048, OR: 4.73, 95% CI: 1.01–22.2) in the low-dose group. Conclusions: A dose reduction of 5-ASA might be cautiously selected in UC patients with a history of steroid use and a shorter duration of disease remission.

AB - Background: 5-Aminosalicylic acids (5-ASA) are effective for ulcerative colitis (UC) as a maintenance therapy. It is not clear when and how to reduce a dose of 5-ASA after inducing remission. We aimed to investigate the clinical characteristics and evaluate the risk factors of relapse for UC patients receiving 5-ASA. Methods: The medical records of prospectively registered UC patients who received oral 5-ASA as maintenance therapy between January and December 31, 2014, were investigated. The patients’ clinical characteristics in a 2-year follow-up were compared between a relapse group and a remission group. Results: Of 527 UC patients receiving only oral 5-ASA, 390 (74.0%) maintained remission and 137 (26.0%) relapsed during the follow-up period. Multivariable analysis indicated that a shorter duration of disease remission (p < 0.001, OR: 1.24, 95% CI: 1.12–1.38) was statistically significant for each comparison between the remission and relapse groups among all the patients. Risk factors for clinical relapse were a shorter duration of disease remission (p <0.001, OR: 1.17, 95% CI: 1.04–1.33) in the high-dose 5-ASA group and a shorter duration of disease remission (p = 0.003, OR: 1.45, 95% CI: 1.13–1.89) and a history of steroid use (p = 0.048, OR: 4.73, 95% CI: 1.01–22.2) in the low-dose group. Conclusions: A dose reduction of 5-ASA might be cautiously selected in UC patients with a history of steroid use and a shorter duration of disease remission.

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U2 - 10.1371/journal.pone.0187737

DO - 10.1371/journal.pone.0187737

M3 - Article

VL - 12

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 11

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