'One more time' 5-ASA retrial after a glucocorticosteroid induced remission in moderate to severe ulcerative colitis: A prospective community practice experience

摘要

The role for re-trial of 5-Aminosalycilic acid (5-ASA) after a glucocorticosteroid (GCS) induced remission in moderate to severe UC remains unchartered.34 of our patients with moderate or severe active UC (Fig. 1) were given the option to restart oral 5-ASA 4.8 g (pH 6.8 formulation) once steroids were tapered to 20 mg and in clinical remission (Table 1).Of the 34 patients who met inclusion criteria, 25 did not wish to retry 5-ASA: 8 could not be tapered to 20 mg oral prednisone and 17 chose immunomodulator and/or biologic therapy, or surgery. Of 17 participating, 2 were non-compliant with medications and 2 were lost to follow up. In the remaining 13, 4 failed 5-ASA therapy in less than 2 weeks. Of those 4 who failed therapy 3 were salvaged on infliximab, and 1 required colectomy. However, 9 of the 13 successfully maintained a response with oral 5-ASA 4.8 g after steroids were discontinued 20 weeks from the last observed visit (range 14-44 weeks) (Table 2).