Inflammatory Bowel Disease Center, Yokohama City University Medical Center, Yokohama, Japan.
Department of Gastroenterology, The University of Tokyo, Tokyo, Japan.
J Gastroenterol Hepatol. 2019 Nov;34(11):1929-1939. doi: 10.1111/jgh.14690. Epub 2019 Jun 20.
Oral 5-aminosalicylic acid (5-ASA) is recommended for the therapy of mild to moderate intestinal Behçet's disease (BD). However, the induction remission efficacy and endoscopic outcomes of 5-ASA are unknown. We investigated remission induction at 8 weeks, endoscopic outcomes until 52 weeks, and event-free survival at 52 weeks in patients with intestinal BD treated with 5-ASA.
Forty-one patients with intestinal BD were treated with oral 5-ASA. Clinical remission was evaluated with the Crohn's disease activity index (CDAI). The endoscopic response was evaluated using the modified global gastrointestinal endoscopic assessment scores. Rescue therapy-free survival and surgery-free survival at 52 weeks were estimated, and predictive factors for a clinical response at weeks 8 and 52 were identified.
Seven patients (17%) withdrew 5-ASA early (≤ 8 weeks) because of adverse events. At week 8, clinical efficacy could be accurately evaluated in 28 patients, and the response and remission rates were 61% and 57%, respectively, using the CDAI. Endoscopic evaluation was achieved in 17 patients up to 52 weeks, and the endoscopic response and remission rates were 71% and 35%, respectively. The probabilities of rescue therapy-free survival and surgery-free survival were 73% and 100%, respectively, at 52 weeks in all 41 patients. The predictive factors for therapeutic effectiveness at week 8 were a higher baseline C-reactive protein level and CDAI, but they were negative predictive factors for a 52-week response.
5-ASA is effective for clinical and endoscopic induction and maintaining a response in patients with mild to moderate intestinal BD.
口服 5-氨基水杨酸（5-ASA）被推荐用于治疗轻度至中度肠型贝赫切特病（BD）。然而，5-ASA 的诱导缓解疗效和内镜结果尚不清楚。我们研究了肠型 BD 患者接受 5-ASA 治疗后 8 周的缓解诱导、52 周的内镜结果和 52 周的无事件生存。
41 例肠型 BD 患者接受口服 5-ASA 治疗。临床缓解采用克罗恩病活动指数（CDAI）评估。内镜反应采用改良全球胃肠内镜评估评分评估。估计 52 周时无救援治疗生存和无手术生存，并确定 8 周和 52 周时临床反应的预测因素。
7 例患者（17%）因不良事件在 8 周内（≤8 周）提前停用 5-ASA。8 周时，28 例患者可准确评估临床疗效，CDAI 缓解率和缓解率分别为 61%和 57%。17 例患者至 52 周时可进行内镜评估，内镜反应率和缓解率分别为 71%和 35%。41 例患者的无救援治疗生存和无手术生存概率分别为 73%和 100%。8 周时的疗效预测因素是较高的基线 C 反应蛋白水平和 CDAI，但它们是 52 周时反应的负预测因素。
5-ASA 对轻度至中度肠型 BD 患者的临床和内镜诱导以及维持缓解有效。
