Picchio Marcello, Elisei Walter, Brandimarte Giovanni, Di Mario Francesco, Malfertheiner Peter, Scarpignato Carmelo, Tursi Antonio
*Division of Surgery, "P. Colombo" Hospital, ASL RMH, Velletri †Division of Gastroenterology, ASL RMH, Albano Laziale ‡Division of Internal Medicine and Gastroenterology, "Cristo Re" Hospital, GIOMI Group, Rome §Department of Clinical & Experimental Medicine, Gastroenterology Unit ¶Department of Clinical & Experimental Medicine, Clinical Pharmacology & Digestive Pathophysiology Unit, University of Parma #Gastroenterology Service, ASL BAT, Andria (BT), Italy ∥Department of Gastroenterology, Hepatology and Infectious Diseases, University of Magdeburg, Magdeburg, Germany.
J Clin Gastroenterol. 2016 Oct;50 Suppl 1:S64-9. doi: 10.1097/MCG.0000000000000669.
Symptomatic uncomplicated diverticular disease (SUDD) is a common gastrointestinal disease, because it affects about one fourth of the patient harboring colonic diverticula.
To assess the effectiveness of mesalazine in improving symptoms (namely abdominal pain) and in preventing diverticulitis occurrence in patients with SUDD.
Only randomized clinical trials (irrespective of language, blinding, or publication status) that compared mesalazine with placebo or any other therapy in SUDD were evaluated. The selected endpoints were symptom relief and diverticulitis occurrence at maximal follow-up. Absolute risk reduction (ARR, with 95% confidence interval) and the number needed to treat were used as measures of the therapeutic effect.
Six randomized clinical trials enrolled 1021 patients: 526 patients were treated with mesalazine and 495 with placebo or other therapies. Symptom relief with mesalazine was always larger than that with placebo and other therapies. However, absolute risk reduction was significant only when mesalazine was compared with placebo, a high-fiber diet, and low-dose rifaximin. The incidence of diverticulitis with mesalazine was lower than that observed with placebo and other treatments, being significant only when compared with placebo.
Mesalazine is effective in achieving symptom relief and primary prevention of diverticulitis in patients with SUDD.
有症状的非复杂性憩室病（SUDD）是一种常见的胃肠道疾病，因为约四分之一患有结肠憩室的患者会受其影响。
评估美沙拉嗪对改善SUDD患者症状（即腹痛）以及预防憩室炎发生的有效性。
仅评估了在SUDD患者中将美沙拉嗪与安慰剂或任何其他疗法进行比较的随机临床试验（不论语言、盲法或发表状态）。选定的终点为最大随访时的症状缓解和憩室炎发生情况。绝对风险降低率（ARR，95%置信区间）和需治疗人数用作治疗效果的衡量指标。
六项随机临床试验纳入了1021例患者：526例患者接受美沙拉嗪治疗，495例患者接受安慰剂或其他疗法治疗。美沙拉嗪的症状缓解情况始终优于安慰剂和其他疗法。然而，仅当美沙拉嗪与安慰剂、高纤维饮食和低剂量利福昔明进行比较时，绝对风险降低才具有显著性。美沙拉嗪治疗的憩室炎发生率低于安慰剂和其他治疗，仅与安慰剂比较时具有显著性。
美沙拉嗪对SUDD患者实现症状缓解和憩室炎一级预防有效。
