Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands.
Department of Gastroenterology and Hepatology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.
Br J Clin Pharmacol. 2018 Mar;84(3):477-481. doi: 10.1111/bcp.13462. Epub 2017 Dec 6.
Adherence is pivotal but challenging in ulcerative colitis (UC) treatment. Many methods to assess adherence are subjective or have limitations. (Nac-)5-aminosalicylic acid (5-ASA) urinalysis by high-performance liquid chromatography (HPLC) seems feasible and reproducible in healthy volunteers. We performed a prospective study in adult quiescent UC patients to evaluate the feasibility of spot (Nac-)5-ASA urinalysis by HPLC to assess adherence in daily inflammatory bowel disease (IBD) care. Twenty-nine patients (51.7% male, mean age 52 ± 11 years) were included (median FU 9 months) and weekly spot urine samples were collected. We found large variation in spot (Nac-)5-ASA urinary excretion that was unrelated to brand, dosing schedule or dosage of 5-ASA. In conclusion, spot (Nac-)5-ASA urinalysis is not applicable to assess 5-ASA adherence in daily IBD care.
在溃疡性结肠炎(UC)治疗中,坚持治疗至关重要,但也具有挑战性。有许多评估依从性的方法,但都存在主观性或局限性。高效液相色谱法(HPLC)的(Nac-)5-氨基水杨酸(5-ASA)尿分析在健康志愿者中似乎是可行且可重复的。我们在成年缓解期 UC 患者中进行了一项前瞻性研究,以评估 HPLC 点(Nac-)5-ASA 尿分析评估日常炎症性肠病(IBD)治疗中依从性的可行性。共纳入 29 例患者(51.7%为男性,平均年龄 52±11 岁),并每周采集点尿样。我们发现 5-ASA 的(Nac-)5-ASA 尿排泄的点存在较大差异,与品牌、剂量方案或剂量无关。总之,点(Nac-)5-ASA 尿分析不适用于评估日常 IBD 治疗中的 5-ASA 依从性。