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Concomitant 5-Aminosalicylate Therapy in Moderate-to-Severe Ulcerative Colitis Patients Escalated to Infliximab Is Not Beneficial.
- Source :
-
Digestive diseases and sciences [Dig Dis Sci] 2021 Nov; Vol. 66 (11), pp. 3985-3992. Date of Electronic Publication: 2020 Nov 13. - Publication Year :
- 2021
-
Abstract
- Background and Aims: While there is recent literature to support the discontinuation of 5-aminosalicylate (5-ASA) upon the initiation of biologics, continuing 5-ASA after treatment failure is relatively common. We aimed to assess the impact of concomitant 5-ASA therapy on clinical outcomes in ulcerative colitis (UC) patients escalated to infliximab.<br />Methods: This is a retrospective chart review of patients with moderate-to-severe UC started on infliximab between January 2012 and December 2017 at the University of Alberta. The primary outcome was clinical remission (partial Mayo score < 2) at 6 and 12 months. Secondary outcomes included endoscopic (endoscopic Mayo < 2) and deep remission (combined clinical and endoscopic remission) as well as the need for rescue therapy, hospitalization or colectomy. Univariate and multivariate logistic regression models were used to estimate the odds ratios and 95% CI for the outcomes.<br />Results: One hundred and twenty-one patients were followed over a period of 47 (SD = 34) months. Patients on 5-ASA had increased concomitant immunomodulator use (73.3% vs. 54.1%, p = 0.03). There was no difference in clinical remission at 6 (aOR 2.59, p = 0.07) or 12 months (aOR 0.43, p = 0.06). At 12 months, patients on concomitant 5-ASA were less likely to achieve endoscopic (aOR 0.08, p = 0.01) and deep remission (aOR 0.07, p = 0.02). Adverse outcomes such as need for rescue therapy, hospitalization, and colectomy did not differ between the groups.<br />Conclusions: Our data suggest that 5-ASA may be stopped in patients with moderate-to-severe UC who have been escalated to infliximab therapy as it has no additional benefit to control inflammation.<br /> (© 2020. Springer Science+Business Media, LLC, part of Springer Nature.)
- Subjects :
- Adult
Anti-Inflammatory Agents, Non-Steroidal administration & dosage
Anti-Inflammatory Agents, Non-Steroidal therapeutic use
Cohort Studies
Drug Therapy, Combination
Female
Gastrointestinal Agents administration & dosage
Gastrointestinal Agents therapeutic use
Humans
Male
Mesalamine adverse effects
Middle Aged
Remission Induction
Retrospective Studies
Young Adult
Colitis, Ulcerative drug therapy
Infliximab administration & dosage
Infliximab therapeutic use
Mesalamine administration & dosage
Mesalamine therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1573-2568
- Volume :
- 66
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Digestive diseases and sciences
- Publication Type :
- Academic Journal
- Accession number :
- 33184796
- Full Text :
- https://doi.org/10.1007/s10620-020-06704-6