Algaba Alicia, Guerra Iván, García García de Paredes Ana, Hernández Tejero María, Ferre Carlos, Bonillo Daniel, Aguilera Lara, López-Sanromán Antonio, Bermejo Fernando
Digestivo, Hospital Universitario de Fuenlabrada, España.
Digestivo, Hospital Universitario de Fuenlabrada.
Rev Esp Enferm Dig. 2017 Feb;109(2):114-121. doi: 10.17235/reed.2016.4620/2016.
To describe how mesalazine (MSZ) is used in our practice in ulcerative colitis (UC), at what dose, and the success rate (regarding adherence to therapy).
Observational, transversal study, including all patients with UC and with MSZ maintenance therapy seen from September 2014 to February 2015 at two IBD units in Spain. Treatment adherence was measured by the Morisky-Green scale.
We included 203 patients (mean MSZ dose: 2.6 ± 1.0 g/d; median of treatment: 19.5 months [IQR: 8-48]). Doses < 2 g/d were used in 15.3% of cases, 2-2.9 g/d doses in 35.0%, 3-3.9 doses in 29.5%, and ≥ 4 g/d doses in the remaining 20.2%. A single daily dose was preferred in 51.2% of cases, two doses in 33.0% and three doses in 15.8%. A different MSZ brand had been previously used in 36.6% of patients. In 134 cases (66%), the maintenance dose had been increased during a flare-up, and in 49 (36.6% of cases) this higher dose had been kept for maintenance (dose ≥ 4 g/d in 36 patients). During the MSZ therapy, 14 patients (6.9%) suffered mild side effects (21.4% altered liver function tests). Therapy adherence was good in 81.8% of cases.
Half of our UC patients take high MSZ doses (≥ 3 g/d) as maintenance therapy, with acceptable safety and good adherence. Half of all patients take a single daily dose, and one third needed a different commercial brand during therapy. Opting for a higher MSZ maintenance dose is a possible strategy for a satisfactory maintenance therapy.
描述美沙拉嗪（MSZ）在我们治疗溃疡性结肠炎（UC）中的应用方式、剂量以及成功率（关于治疗依从性）。
观察性横断面研究，纳入2014年9月至2015年2月在西班牙两个炎症性肠病治疗中心接受MSZ维持治疗的所有UC患者。采用Morisky - Green量表测量治疗依从性。
我们纳入了203例患者（MSZ平均剂量：2.6±1.0 g/d；治疗中位数：19.5个月[四分位间距：8 - 48]）。15.3%的病例使用剂量<2 g/d，35.0%使用2 - 2.9 g/d剂量，29.5%使用3 - 3.9 g/d剂量，其余20.2%使用≥4 g/d剂量。51.2%的病例首选每日单次剂量，33.0%为每日两次剂量，15.8%为每日三次剂量。36.6%的患者之前使用过不同品牌的MSZ。134例（66%）患者在病情发作期间维持剂量增加，49例（占病例的36.6%）维持了较高剂量（36例患者剂量≥4 g/d）。在MSZ治疗期间，14例患者（6.9%）出现轻度副作用（21.4%肝功能检查异常）。81.8%的病例治疗依从性良好。
我们一半的UC患者接受高剂量MSZ（≥3 g/d）作为维持治疗，安全性可接受且依从性良好。所有患者中有一半每日服用单次剂量，三分之一的患者在治疗期间需要更换不同的商业品牌。选择较高的MSZ维持剂量可能是实现满意维持治疗的一种策略。
