Shimodaira Yosuke, Onochi Kengo, Watanabe Kenta, Takahashi So, Fukuda Sho, Watanabe Noboru, Koizumi Shigeto, Matsuhashi Tamotsu, Iijima Katsunori
Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, Akita, Japan.
Division of Gastroenterology, Omagari Kosei Medical Center, Daisen, Japan.
Intest Res. 2021 Apr;19(2):225-231. doi: 10.5217/ir.2020.00023. Epub 2020 Aug 18.
BACKGROUND/AIMS: 5-Aminosalicylic acid (5-ASA) is a basic drug for inducing and maintaining remission for ulcerative colitis. One of its formulations has a coating with a pH-dependent degradation that ensures the release 5-ASA at the terminal ileum. No evidence has been shown concerning the effects of proton pump inhibitors (PPIs) or H2 receptor antagonists (H2RAs) on the clinical course of ulcerative colitis patients in remission. The present study assessed the effect of PPIs or H2RAs on the relapse of ulcerative colitis patients in clinical remission maintained by pH-dependent released 5-ASA.
Ulcerative colitis patients who had been prescribed time- or pH-dependent-released 5-ASA between January 2015 and December 2018 were enrolled in this multicenter retrospective study. The period of remission until relapse occurred was analyzed among the patients taking time-dependent-released 5-ASA or pH-dependent-released 5-ASA with/without PPIs or H2RAs.
One hundred and nineteen patients were analyzed in this study. In the primary endpoint, the relapse rate was higher in patients taking pH-dependent-released 5-ASA and PPIs or H2RAs than in those taking the pH-dependent-released 5-ASA without PPIs or H2RAs, while the relapse rate was similar in patients taking the time-dependent-released 5-ASA with or without PPIs or H2RAs concomitantly. Patients with a short duration of disease and middle-aged patients more frequently showed relapse with PPIs or H2RAs than the other patients.
The coadministration of PPIs or H2RAs affects the clinical course of ulcerative colitis in remission maintained by pH-dependent-released 5-ASA.
背景/目的：5-氨基水杨酸（5-ASA）是诱导和维持溃疡性结肠炎缓解的基础药物。其一种制剂具有pH依赖性降解包衣，可确保5-ASA在回肠末端释放。尚无证据表明质子泵抑制剂（PPI）或H2受体拮抗剂（H2RA）对处于缓解期的溃疡性结肠炎患者临床病程的影响。本研究评估了PPI或H2RA对由pH依赖性释放的5-ASA维持临床缓解的溃疡性结肠炎患者复发的影响。
纳入2015年1月至2018年12月期间开具了时间或pH依赖性释放5-ASA的溃疡性结肠炎患者进行这项多中心回顾性研究。分析了服用时间依赖性释放5-ASA或pH依赖性释放5-ASA并伴有/不伴有PPI或H2RA的患者直至复发的缓解期。
本研究共分析了119例患者。在主要终点方面，服用pH依赖性释放5-ASA及PPI或H2RA的患者复发率高于未服用PPI或H2RA的服用pH依赖性释放5-ASA的患者，而同时服用或未服用PPI或H2RA的时间依赖性释放5-ASA的患者复发率相似。病程短的患者和中年患者与其他患者相比，使用PPI或H2RA时更易复发。
PPI或H2RA的联合使用会影响由pH依赖性释放的5-ASA维持缓解的溃疡性结肠炎患者的临床病程。
