Department of General Internal Medicine, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany.
Digestive Health Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
J Crohns Colitis. 2020 Sep 16;14(9):1274-1281. doi: 10.1093/ecco-jcc/jjaa041.
Patients with ulcerative colitis [UC] require rapid and complete relief of symptoms, particularly stool frequency and rectal bleeding. The aim of this study was to determine time to symptom resolution in patients with UC during induction treatment with multimatrix mesalazine, and the proportion of patients remaining symptom-free and in endoscopic remission after 12 months of maintenance.
A pooled analysis of 5 pivotal clinical trials, including >1300 patients, evaluating multimatrix mesalazine for treatment of mild-to-moderate active UC was conducted. Time to symptom resolution was defined as the period between first drug dosage date and first 3 consecutive days of induction therapy when the patient achieved a score of 0 [normal] on a modified UC Disease Activity Index for stool frequency and/or rectal bleeding.
Median [95% confidence interval] time to resolution of stool frequency was 52 (45-not estimable [NE]) days for placebo versus 38 [34-41] days for multimatrix mesalazine [combined dose groups, 2.4 or 4.8 g/day]; time to resolution of rectal bleeding was 35 [20-NE] days for placebo versus 15 [14-17] days for multimatrix mesalazine [combined dose groups]. Among those who achieved resolution of both stool frequency and rectal bleeding during induction, 67.4% maintained symptom scores of 0 at Month 12. No relationship was observed between rapidity of symptom resolution during induction treatment and achievement of endoscopic remission at Month 12.
Induction with multimatrix mesalazine provided rapid and prolonged symptom resolution in addition to endoscopic remission at Month 12.
溃疡性结肠炎(UC)患者需要迅速和完全缓解症状,尤其是粪便频率和直肠出血。本研究的目的是确定在诱导治疗中使用多基质美沙拉嗪治疗 UC 患者的症状缓解时间,以及在 12 个月的维持治疗后无症状和内镜缓解的患者比例。
对 5 项关键性临床试验进行了汇总分析,共纳入了>1300 例患者,评估多基质美沙拉嗪治疗轻度至中度活动期 UC 的疗效。症状缓解时间定义为从首次用药日期到诱导治疗的前 3 天,在此期间,患者的改良 UC 疾病活动指数的粪便频率和/或直肠出血评分达到 0(正常)。
安慰剂组粪便频率缓解的中位数[95%置信区间]为 52(45-不可估计[NE])天,多基质美沙拉嗪组为 38[34-41]天[联合剂量组,2.4 或 4.8 g/天];安慰剂组直肠出血缓解的中位数[95%置信区间]为 35[20-NE]天,多基质美沙拉嗪组为 15[14-17]天[联合剂量组]。在诱导期同时缓解粪便频率和直肠出血的患者中,67.4%在第 12 个月时保持症状评分 0。在诱导治疗期间症状缓解的速度与第 12 个月时达到内镜缓解之间没有观察到关系。
多基质美沙拉嗪诱导治疗可迅速和持久缓解症状,同时在第 12 个月时达到内镜缓解。