电子健康：通过基于网络的自我管理解决方案实现美沙拉嗪治疗轻至中度溃疡性结肠炎的个体化。

eHealth: individualization of mesalazine treatment through a self-managed web-based solution in mild-to-moderate ulcerative colitis.

作者信息

Pedersen Natalia, Thielsen Peter, Martinsen Lars, Bennedsen Mette, Haaber Anne, Langholz Ebbe, Végh Zsuzsanna, Duricova Dana, Jess Tine, Bell Sally, Burisch Johan, Munkholm Pia

机构信息

*Gastroenterology Unit, Herlev University Hospital, Copenhagen, Denmark; †Department of Gastroenterology, Nykoebing Falster Hospital, Nykoebing Falster, Denmark; ‡Department of Gastroenterology, Nordsjaellands Hospital, Frederikssund, Denmark; §Department of Gastroenterology, Gentofte Hospital, Gentofte, Denmark; ‖IBD Clinical and Research Center, ISCARE a. s., Charles University, Prague, Czech Republic; ¶Department of Epidemiology Research, States Serum Institute, Copenhagen, Denmark; and **Department of Gastroenterology, St. Vincent's University Hospital, Melbourne, Australia.

出版信息

Inflamm Bowel Dis. 2014 Dec;20(12):2276-85. doi: 10.1097/MIB.0000000000000199.

DOI:10.1097/MIB.0000000000000199

PMID:25248002

Abstract

BACKGROUND

To individualize treatment with mesalazine for ulcerative colitis relapses through a self-managed, web-based solution to optimize the short-term disease course.

METHODS

Prospective, open-label, web-guided study with 3 months mesalazine therapy among patients with mild-to-moderate ulcerative colitis. Once a week, patients completed the simple clinical colitis activity index (SCCAI) and registered fecal calprotectin (FC) on the web application: www.meza.constant-care.dk. SCCAI and FC were summed and resulted in a total inflammatory burden score (TIBS). Deep remission was defined as SCCAI ≤1; FC = 0, and TIBS ≤1.

RESULTS

A total of 95 patients (62% females; median age 45 yr) were included in the study and allocated 4.8 g mesalazine per day. Of these, 82 (86%) patients were adherent to web therapy, completing 3 months of web-guided mesalazine therapy. Of the 82 adherent patients, 72 (88%) continued mesalazine and 10 (12%) needed rescue therapy. From weeks 0 to 12, patients had experienced a significant reduction in mean SCCAI (4.6 versus 1.6, P < 0.001), mean FC (437 versus 195, P < 0.001), and mean TIBS (6.7 versus 2.4, P < 0.001). Based on TIBS values (≤1), the dose of mesalazine was reduced to 2.4 g in 25% of patients at week 3 in 50% of subjects at week 5 and in 88% of patients at week 12.

CONCLUSIONS

Web-guided therapy with mesalazine in mild-to-moderate ulcerative colitis helps to individualize the dose and improve adherence to therapy. The study confirms mesalazine efficacy in mild-to-moderate UC, significantly improving TIBS values in majority of the patients.

摘要

背景

通过基于网络的自我管理解决方案，使美沙拉嗪治疗溃疡性结肠炎复发的方案个体化，以优化短期病程。

方法

对轻度至中度溃疡性结肠炎患者进行前瞻性、开放标签、网络指导的研究，给予3个月的美沙拉嗪治疗。患者每周一次在网络应用程序（www.meza.constant-care.dk）上完成简单临床结肠炎活动指数（SCCAI）并记录粪便钙卫蛋白（FC）。将SCCAI和FC相加得出总炎症负担评分（TIBS）。深度缓解定义为SCCAI≤1；FC = 0，且TIBS≤1。

结果

共有95例患者（62%为女性；中位年龄45岁）纳入研究，每天给予4.8克美沙拉嗪。其中，82例（86%）患者坚持网络治疗，完成了3个月的网络指导美沙拉嗪治疗。在这82例坚持治疗的患者中，72例（88%）继续使用美沙拉嗪，10例（12%）需要救援治疗。从第0周开始至第12周，患者的平均SCCAI（4.6对1.6，P < 0.001）、平均FC（437对195，P < 0.001）和平均TIBS（6.7对2.4，P < 0.001）均显著降低。基于TIBS值（≤1），25%的患者在第3周时美沙拉嗪剂量减至2.4克，50%的受试者在第5周时减至该剂量，88%的患者在第12周时减至该剂量。