TY - JOUR
T1 - Efficacy of Topical 5-Aminosalicylates in Preventing Relapse of Quiescent Ulcerative Colitis
T2 - A Meta-analysis
AU - Ford, Alexander C.
AU - Khan, Khurram J.
AU - Sandborn, William J.
AU - Hanauer, Stephen B.
AU - Moayyedi, Paul
N1 - Funding Information:
Conflicts of interest These authors disclose the following: William J. Sandborn has served as a consultant to Ferring Pharmaceuticals, Proctor and Gamble Pharmaceuticals, Salix Pharmaceuticals, Shire Pharmaceuticals, and Warner Chilcott and has received research support from Proctor and Gamble Pharmaceuticals, Salix Pharmaceuticals, Shire Pharmaceuticals, and Warner Chilcott. Stephen B. Hanauer has served as a consultant to Centocor, Abbott, UCB Pharma, Elan, and Biogen and has received research support from Centocor, Abbott, and UCB Pharma. Paul Moayyedi serves as chair at McMaster University that is partly funded by an unrestricted donation by AstraZeneca and has received consultant's and speaker's bureau fees from AstraZeneca, AxCan Pharma, Nycomed, and Johnson and Johnson. The remaining authors disclose no conflicts.
Funding Information:
Funding Supported by the American College of Gastroenterology.
Copyright:
Copyright 2012 Elsevier B.V., All rights reserved.
PY - 2012/5
Y1 - 2012/5
N2 - Background & Aims: Topical 5-aminosalicylates (5-ASAs) such as mesalamine are effective in inducing remission in patients with mild to moderately active ulcerative colitis (UC). However, there has been no meta-analysis of their efficacy in preventing relapse of quiescent UC. Methods: We searched MEDLINE, EMBASE, and the Cochrane central register of controlled trials through July 2011 for randomized controlled trials comparing the effects of topical 5-ASAs with placebo in adults with quiescent UC. Dichotomous data were pooled to obtain relative risk (RR) of relapse of disease activity. The number needed to treat (NNT) was calculated from the reciprocal of the risk difference. Adverse events data were summarized. Results: The search identified 3061 citations; we analyzed data from seven (555 patients). All trials used mesalamine, but only one included patients with extensive disease. The duration of therapy ranged from 6-24 months. The RR of relapse of disease activity in patients with quiescent UC who were given topical mesalamine, compared with placebo, was 0.60 (95% confidence interval, 0.49-0.73; NNT = 3); there was no significant heterogeneity between studies (I 2 = 21%, P = .27). No significant differences in rates of adverse events rates were detected (RR = 1.01; 95% confidence interval, 0.59-1.72). Conclusions: On the basis of a meta-analysis of 7 randomized controlled trials, topical mesalamine is effective in preventing relapse of quiescent UC, with no greater number of adverse events than placebo. However, because most studies included only patients with left-sided disease or proctitis, the efficacy of topical mesalamine in preventing relapse in patients with more extensive quiescent UC is not known.
AB - Background & Aims: Topical 5-aminosalicylates (5-ASAs) such as mesalamine are effective in inducing remission in patients with mild to moderately active ulcerative colitis (UC). However, there has been no meta-analysis of their efficacy in preventing relapse of quiescent UC. Methods: We searched MEDLINE, EMBASE, and the Cochrane central register of controlled trials through July 2011 for randomized controlled trials comparing the effects of topical 5-ASAs with placebo in adults with quiescent UC. Dichotomous data were pooled to obtain relative risk (RR) of relapse of disease activity. The number needed to treat (NNT) was calculated from the reciprocal of the risk difference. Adverse events data were summarized. Results: The search identified 3061 citations; we analyzed data from seven (555 patients). All trials used mesalamine, but only one included patients with extensive disease. The duration of therapy ranged from 6-24 months. The RR of relapse of disease activity in patients with quiescent UC who were given topical mesalamine, compared with placebo, was 0.60 (95% confidence interval, 0.49-0.73; NNT = 3); there was no significant heterogeneity between studies (I 2 = 21%, P = .27). No significant differences in rates of adverse events rates were detected (RR = 1.01; 95% confidence interval, 0.59-1.72). Conclusions: On the basis of a meta-analysis of 7 randomized controlled trials, topical mesalamine is effective in preventing relapse of quiescent UC, with no greater number of adverse events than placebo. However, because most studies included only patients with left-sided disease or proctitis, the efficacy of topical mesalamine in preventing relapse in patients with more extensive quiescent UC is not known.
KW - Clinical Trial
KW - Colon
KW - Drug Treatment
KW - Inflammation
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UR - http://www.scopus.com/inward/citedby.url?scp=84859857709&partnerID=8YFLogxK
U2 - 10.1016/j.cgh.2011.10.043
DO - 10.1016/j.cgh.2011.10.043
M3 - Review article
C2 - 22083024
AN - SCOPUS:84859857709
SN - 1542-3565
VL - 10
SP - 513
EP - 519
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
IS - 5
ER -