Inflammatory Bowel Disease Centre, Yokkaichi Social Insurance Hospital, 10-8 Hazuyamacho, Yokkaichi, Mie 510-0016, Japan.
Dig Liver Dis. 2011 May;43(5):386-90. doi: 10.1016/j.dld.2010.11.016. Epub 2010 Dec 30.
Mesalazine is often used to maintain remission in patients with ulcerative colitis.
To investigate if increasing the dose of mesalazine is safe and effective for patients with ulcerative colitis who relapse under low-dose maintenance therapy.
Ninety consecutive patients who relapsed during maintenance therapy with oral mesalazine at 1.5-2.25g/day were included. All patients had mildly or moderately active ulcerative colitis at entry, and were treated with oral mesalazine at 4.0g/day for the following 8 weeks. At entry and week 8, endoscopic examinations were carried out to assess the severity of endoscopic inflammation. The primary as well as the secondary endpoints were clinical and endoscopic improvements at week 8.
No patient experienced any serious side effect, and the treatment with 4.0g/day mesalazine over the 8 week period was well tolerated by all patients. Fifty-nine patients (66%) achieved clinical improvement in stool frequency and/or rectal bleeding including 40 (44%) with clinical remission (normal stool frequency and no rectal bleeding). Forty-three patients (48%) showed endoscopic improvement including 25 (28%) with endoscopic remission.
Increasing the dose of mesalazine up to 4.0g/day appeared to be safe and effective for patients who relapsed under low-dose, 1.5-2.25g/day maintenance therapy.
美沙拉嗪常用于维持溃疡性结肠炎患者的缓解期。
研究在低剂量维持治疗下复发的溃疡性结肠炎患者增加美沙拉嗪剂量是否安全有效。
连续纳入 90 例在 1.5-2.25g/天口服美沙拉嗪维持治疗期间复发的患者。所有患者在入组时均患有轻度或中度活动期溃疡性结肠炎，并接受 4.0g/天的口服美沙拉嗪治疗，为期 8 周。在入组时和第 8 周进行内镜检查，以评估内镜炎症的严重程度。主要和次要终点是第 8 周的临床和内镜改善。
没有患者出现任何严重的不良反应，所有患者均能耐受 4.0g/天美沙拉嗪治疗 8 周。59 例（66%）患者的粪便频率和/或直肠出血改善，包括 40 例（44%）患者达到临床缓解（粪便频率正常，无直肠出血）。43 例（48%）患者内镜改善，包括 25 例（28%）患者内镜缓解。
对于在低剂量（1.5-2.25g/天）维持治疗下复发的患者，增加美沙拉嗪剂量至 4.0g/天似乎是安全且有效的。
