The gap between scientific evidence and clinical practice: 5-aminosalicylates are frequently used for the treatment of Crohn's disease.

Background There is uncertain evidence of effectiveness of 5-aminosalicylates (5- ASA) to induce and maintain response and remission of active Crohn's disease ( CD), and weak evidence to support their use in post-operative CD. Aim To assess the frequency and determinants of 5- ASA use in CD patients and to evaluate the physicians' perception of clinical response and side effects to 5- ASA. Methods Data from the Swiss Inflammatory Bowel Disease Cohort, which collects data since 2006 on a large sample of IBD patients, were analysed. Information from questionnaires regarding utilisation of treatments and perception of response to 5- ASA were evaluated. Logistic regression modelling was performed to identify factors associated with 5- ASA use. Results Of 1420 CD patients, 835 (59%) were ever treated with 5- ASA from diagnosis to latest follow-up. Disease duration >10 years and colonic location were both significantly associated with 5- ASA use. 5- ASA treatment was judged to be successful in 46% (378/825) of treatment episodes (physician global assessment). Side effects prompting stop of therapy were found in 12% (98/825) episodes in which 5- ASA had been stopped. Conclusions 5-Aminosalicylates were frequently prescribed in patients with Crohn's disease in the Swiss IBD cohort. This observation stands in contrast to the scientific evidence demonstrating a very limited role of 5- ASA compounds in the treatment of Crohn's disease. [ABSTRACT FROM AUTHOR]