In a prospective, multicenter, inception cohort study (JPGN 2013; 56: 12-18) with 213 newly diagnosed ulcerative colitis (UC) patients, oral aminosalicylate (5-ASA) therapy was effective in 86 (40%). That is, 40% were considered to be in corticosteroid-free remission at 1 year using 5-ASA as primary maintenance therapy.
This study took place between 2002-2010. Of 1669 children enrolled in the registry from 32 sites, 440 (26%) were diagnosed with UC. Of this group, 353 had followup >1 year and 213 met inclusion/exclusion criteria; all patients had to be treated with only 5-ASA or corticosteroids in the initial 30 days following diagnosis. Most of those excluded had other therapies. Among those with primary oral 5-ASA treatment, only 98 started treatment without a steroid induction.
Some interesting aspects of the study group:
- 82% had pancolitis
- 62% had moderate/severe disease at diagnosis based on physician global assessment
- No laboratory or clinical features were associated with a higher likelihood of response
- Mean daily dosage of 5-ASA was 52 mg/kg/day; 23% had a dose >60 mg/kg/day
The authors note that improved patient adherence and possibly higher 5-ASA dosing schedules may improve response to 5-ASA treatment.
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