Ogata Haruhiko, Ohori Akihiro, Nishino Haruo, Mizushima Seiichi, Hagino Atsushi, Hibi Toshifumi
Center for Diagnostic and Therapeutic Endoscopy, Keio University Hospital, Tokyo, Japan.
Inogashiradori Proctology and Gastroenterology Clinic, Tokyo, Japan.
Intest Res. 2017 Jul;15(3):358-367. doi: 10.5217/ir.2017.15.3.358. Epub 2017 Jun 12.
BACKGROUND/AIMS: This study compared the efficacy of once-daily administration of multimatrix mesalazine 2.4 g/day with multiple-dose mesalazine for the maintenance of remission.
In this multicenter, randomized, double-blind study, 203 patients with ulcerative colitis in remission received multimatrix mesalazine 2.4 g/day once-daily or time-dependent (controlled-release) mesalazine 2.25 g/day 3 times-daily for 48 weeks. The primary efficacy endpoint was the proportion of patients without rectal bleeding.
The proportion of patients without rectal bleeding during the 48-week treatment period in the per protocol set was 84.8% (84/99) in the multimatrix mesalazine 2.4 g/day group and 78.0% (78/100) in the controlled-release mesalazine 2.25 g/day group. The difference between the 2 treatment groups was 6.8% (two-sided 95% confidence interval, -3.9% to 17.6%). The noninferiority margin of -10% was met in the comparison of multimatrix mesalazine 2.4 g/day once-daily with controlled-release mesalazine 2.25 g/day. Multimatrix mesalazine 2.4 g/day once-daily demonstrated consistent efficacy in all subgroups. There was no difference between the 2 treatment groups with regard to safety.
A once-daily dose of 2 multimatrix mesalazine tablets (2.4 g) was not inferior to controlled-release mesalazine 2.25 g/day 3 times-daily in maintaining absence of rectal bleeding in ulcerative colitis.
背景/目的:本研究比较了每日一次服用多基质美沙拉嗪2.4克/天与多次服用美沙拉嗪维持缓解的疗效。
在这项多中心、随机、双盲研究中,203例处于缓解期的溃疡性结肠炎患者接受每日一次服用多基质美沙拉嗪2.4克/天或每日三次服用时间依赖性(缓释)美沙拉嗪2.25克/天,持续48周。主要疗效终点是无直肠出血的患者比例。
在意向性分析集中,多基质美沙拉嗪2.4克/天组在48周治疗期间无直肠出血的患者比例为84.8%(84/99),缓释美沙拉嗪2.25克/天组为78.0%(78/100)。两组之间的差异为6.8%(双侧95%置信区间,-3.9%至17.6%)。每日一次服用多基质美沙拉嗪2.4克与每日三次服用缓释美沙拉嗪2.25克的比较达到了-10%的非劣效性界值。每日一次服用多基质美沙拉嗪2.4克在所有亚组中均显示出一致的疗效。两组在安全性方面无差异。
每日一次服用两片多基质美沙拉嗪(2.4克)在维持溃疡性结肠炎无直肠出血方面不劣于每日三次服用缓释美沙拉嗪2.25克。