- 作者：Javier Martí ; nez Gonzá ; lez ; martinez.gonzalez.javier@gmail.com ; Victoria Busto Bea ; Francisco Mesonero Gismero ; Sofí ; a Parejo Carbonell ; Elena Garrido ; Antonio Ló ; pez San Romá ; n
- 关键词：Enfermedad inflamatoria intestinal ; Colitis ulcerosa ; Sulfasalazina ; Mesalazina
- 刊名：Gastroenterolog¨ªa y Hepatolog¨ªa
- 出版年：2013
- 出版时间：January, 2013
- 年：2013
- 卷：36
- 期：1
- 页码：7-10
- 全文大小：162 K
Introduction
In ulcerative colitis, aminosalicylates are the mainstay of maintenance therapy. Sulfasalazine was the first aminosalicylic used in the maintenance therapy of this disease. Later, mesalazine was preferred due to its supposedly better tolerability. However, recent studies indicate certain benefits of the use of sulfasalazine because of its possible superior effectiveness. The aim of this study was to determine whether patients with ulcerative colitis poorly controlled by mesalazine as maintenance therapy respond to sulfasalazine, thus avoiding the use of immunosuppressive or biological therapies.
Methods
The Inflammatory Bowel Disease Clinic of the Ram¨®n y Cajal Hospital maintains a database in which all drug exposures are registered. We selected patients poorly controlled with mesalazine who had received sulfasalazine as rescue maintenance therapy. We determined the percentage of patients poorly controlled with mesalazine who responded to sulfasalazine.
Results
Of 415 patients with ulcerative colitis, 49 had been treated with sulfasalazine at some time. Of these, sulfasalazine was selected as an alternative therapy due to poor disease control with mesalazine. The median duration of mesalazine therapy until the switch was 20.8 months, with a median dose of 3.35 g/day. In 21 of the 31 patients (67.7 % ), sulfasalazine was able to control symptoms and maintain remission.
Conclusion
Despite the limitations of this study, we found that 67.7 % of patients with ulcerative colitis poorly controlled with mesalazine responded to a switch to sulfasalazine. These patients would normally have progressed to immunosuppressive, biological or surgical treatments. This option merits further studies. Meanwhile sulfasalazine should not be forgotten in the management of ulcerative colitis.