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美沙拉嗪缓释片治疗活动期溃疡性结肠炎的中国多中心单盲随机对照研究

Mesalazine Modified-Release Tablet in the Treatment of Ulcerative Colitis in the Active Phase: A Chinese, Multicenter, Single-Blind, Randomized Controlled Study.

作者信息

Sun Jing, Yuan Yaozong

机构信息

Ruijin Hospital Shanghai Jiaotong University School of Medicine, Shanghai, China.

出版信息

Adv Ther. 2016 Mar;33(3):400-9. doi: 10.1007/s12325-016-0303-z. Epub 2016 Feb 22.

Abstract

INTRODUCTION

This study compared the efficacy and safety of two mesalazine formulations in the treatment of Chinese patients with mildly to moderately active ulcerative colitis (UC).

METHODS

In this multicenter, single-blind, randomized controlled study of 251 patients with active UC conducted from November 2010 to January 2012, subjects were randomized to treatment with mesalazine modified-release tablets (MR group, n = 123) or enteric-coated tablets (EC group, n = 128) at 800 mg three-times daily for 8 weeks. The primary efficacy measure was the decrease in UC Disease Activity Index (UCDAI) at final evaluation. If the 95% confidence interval (CI) lower limit of the difference of the decrease in UCDAI between groups was over -1.0, mesalazine modified-release tablets were considered non-inferior to mesalazine enteric-coated tablets. The change in UCDAI in patients with mild and moderate (UCDAI 3-5 and 6-8 at enrollment, respectively) UC was analyzed. Secondary efficacy measures were remission and efficacy rates. Incidences of adverse drug reactions (ADRs) were calculated.

RESULTS

The decreases in UCDAI at final evaluation were 2.84 and 2.56 in the MR and EC groups, respectively, with a difference of 0.27 between groups (95% CI -0.34, 0.88). The remission rates were 48.33% (58/120) and 55.65% (69/124), and the efficacy rates were 63.33% (76/120) and 66.94% (83/124) in the MR and EC groups, respectively (all P > 0.05). In patients with mild UC, the decreases in UCDAI were 2.16 and 2.05 in the MR and EC groups, respectively, while in patients with moderate UC they were 3.49 and 3.03, respectively (all P > 0.05). The incidences of ADRs in the MR and EC groups were 6.61% (8/121) and 10.24% (13/127), respectively (P > 0.05). No serious ADRs were reported during the study.

CONCLUSION

Mesalazine modified-release tablets are non-inferior to enteric-coated tablets and are an effective and safe treatment option in Chinese patients with mildly to moderately active UC.

TRIAL REGISTRATION

ClinicalTrials.gov identifier: NCT01257386.

FUNDING

Tillotts Pharma AG.

摘要

引言

本研究比较了两种美沙拉嗪制剂治疗中国轻至中度活动性溃疡性结肠炎(UC)患者的疗效和安全性。

方法

在2010年11月至2012年1月进行的一项针对251例活动性UC患者的多中心、单盲、随机对照研究中,受试者被随机分为接受美沙拉嗪缓释片治疗组(MR组,n = 123)或肠溶衣片治疗组(EC组,n = 128),每日3次,每次800 mg,共8周。主要疗效指标为最终评估时UC疾病活动指数(UCDAI)的下降情况。如果两组UCDAI下降差值的95%置信区间(CI)下限超过-1.0,则认为美沙拉嗪缓释片不劣于美沙拉嗪肠溶片。分析了轻度和中度UC患者(入组时UCDAI分别为≤3-5分和6-8分)的UCDAI变化。次要疗效指标为缓解率和有效率。计算药物不良反应(ADR)的发生率。

结果

最终评估时,MR组和EC组的UCDAI下降值分别为2.84和2.56,组间差值为0.27(95%CI -0.34,0.88)。MR组和EC组的缓解率分别为48.33%(58/120)和55.65%(69/124),有效率分别为63.33%(76/120)和66.94%(83/124)(均P>0.05)。在轻度UC患者中,MR组和EC组的UCDAI下降值分别为2.16和2.05,而在中度UC患者中分别为3.49和3.03(均P>0.05)。MR组和EC组的ADR发生率分别为6.61%(8/121)和10.24%(13/127)(P>0.05)。研究期间未报告严重ADR。

结论

美沙拉嗪缓释片不劣于肠溶片,是治疗中国轻至中度活动性UC患者的一种有效且安全的治疗选择。

试验注册

ClinicalTrials.gov标识符:NCT01257386。

资助

Tillotts Pharma AG。

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