Effect of weekend 5-aminosalicylic acid (mesalazine) enema as maintenance therapy for ulcerative colitis: Results from a randomized controlled study

Hiroshi Yokoyama, Sho Takagi, Shinichi Kuriyama, Shuichiro Takahashi, Hiroki Takahashi, Masahiro Iwabuchi, Seiichi Takahashi, Yoshitaka Kinouchi, Nobuo Hiwatashi, Ichiro Tsuji, Tooru Shimosegawa

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43 Citations (Scopus)

Abstract

Background: 5-Aminosalicylic acid (5-ASA) is known to be effective in the treatment of active ulcerative colitis (UC). The aim of the current study was to investigate the effect of 5-ASA enemas, as a maintenance therapy for UC, when administered twice weekly as a weekend treatment regimen, compared to daily oral 5-ASA alone. We hypothesized that the weekend enema therapy would be better tolerated by patients who worked or attended school. Methods: Between January 2004 and August 2005, patients with UC, in whom remission of the condition had just been induced, were randomly assigned to either: the weekend 5-ASA enema group (n = 11), who received 1 g 5-ASA enemas twice a week on Saturday and Sunday plus oral 5-ASA 3 g/day for 7 days, or to the daily oral 5-ASA use only group (n = 13), who received only oral 5-ASA 3 g/day for 7 days. The primary endpoint of the study was defined as the incidence of relapse. The study was stopped after 24 patients had been enrolled because an interim analysis showed a significant benefit of the weekend 5-ASA enema group. Results: In the weekend enema group, 2 patients (18.2%) had relapses compared with 10 (76.9%) in the oral 5-ASA only group. The multivariate hazard ratio of relapse associated with weekend 5-ASA enema, relative to the oral alone group, was 0.19 (95% confidence interval, 0.04-0.94). Conclusions: This study demonstrated the beneficial effects of adding weekend 1 g 5-ASA enema to daily 3 g oral 5-ASA as maintenance therapy for UC.

Original languageEnglish
Pages (from-to)1115-1120
Number of pages6
JournalInflammatory Bowel Diseases
Volume13
Issue number9
DOIs
Publication statusPublished - 2007 Sep

Keywords

  • 5-ASA
  • Enema
  • Maintenance therapy
  • Randomized controlled trial
  • Ulcerative colitis

ASJC Scopus subject areas

  • Immunology and Allergy
  • Gastroenterology

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