Review article: withdrawal of 5-aminosalicylates in inflammatory bowel disease.
06 января 2021 года
08:01
Review article: withdrawal of 5-aminosalicylates in inflammatory bowel disease.
Текст новости:
Title: Review article: withdrawal of 5-aminosalicylates in inflammatory bowel disease.
Author, co-author: Chapman, Thomas P.; Frias Gomes, Catarina; Louis, Edouard; Colombel, Jean-Frédéric; Satsangi, Jack
Abstract: BACKGROUND: 5-aminosalicylates (5-ASA) are widely used in inflammatory bowel disease (IBD), but emerging evidence suggests that they may be safely withdrawn in significant subsets of patients. This is important to address: 5-ASA therapy accounts for up to 25% of total healthcare costs in ulcerative colitis (UC), while almost a third of patients with Crohn's disease (CD) receive long-term 5-ASA despite no clear evidence of benefit. Further, rationalising medication burden may improve overall adherence and outcome. AIMS: To summarise the rationale for 5-ASA withdrawal, review the current evidence in both UC and CD and consider the data surrounding colorectal cancer (CRC) prevention, guiding an evidence-based withdrawal strategy. METHODS: PubMed was searched to identify relevant studies. Only papers published in English were reviewed, with priority given to randomised clinical trials and meta-analyses. RESULTS: For patients with UC, consideration of 5-ASA withdrawal should be made on a case-by-case basis, but it appears safest for those in deep remission without any of the following risk factors: younger age (


Текст со страницы (автоматическое получение):
Review article: withdrawal of 5-aminosalicylates in inflammatory bowel disease.
Language :
Keywords :
[en] Aminosalicylic Acids/therapeutic use ; Colitis, Ulcerative/drug therapy ; Colorectal Neoplasms/prevention & control ; Crohn Disease/drug therapy ; Humans ; Randomized Controlled Trials as Topic ; Withholding Treatment
Abstract :
[en] BACKGROUND: 5-aminosalicylates (5-ASA) are widely used in inflammatory bowel disease (IBD), but emerging evidence suggests that they may be safely withdrawn in significant subsets of patients. This is important to address: 5-ASA therapy accounts for up to 25% of total healthcare costs in ulcerative colitis (UC), while almost a third of patients with Crohn's disease (CD) receive long-term 5-ASA despite no clear evidence of benefit. Further, rationalising medication burden may improve overall adherence and outcome. AIMS: To summarise the rationale for 5-ASA withdrawal, review the current evidence in both UC and CD and consider the data surrounding colorectal cancer (CRC) prevention, guiding an evidence-based withdrawal strategy. METHODS: PubMed was searched to identify relevant studies. Only papers published in English were reviewed, with priority given to randomised clinical trials and meta-analyses. RESULTS: For patients with UC, consideration of 5-ASA withdrawal should be made on a case-by-case basis, but it appears safest for those in deep remission without any of the following risk factors: younger age (
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