Comparison of Concomitant Mesalamine and Immunomodulator Therapy and Immunomodulator Monotherapy for Crohn’s Disease
Background. Although immunomodulators are increasingly used in Crohn’s disease (CD), a significant number of gastroenterologists still use 5-aminosalicylate (5-ASA) in combination with azathioprine (AZA) or 6-mercaptopurine (6-MP); there is limited evidence regarding the benefit of concomitant 5-ASA...
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| Format: | Article |
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Wiley
2018-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2018/4826973 |
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| author | Min Seob Kwak Kyung-Jo Kim Jae Hee Cheon Wan Soo Kim Jeong-Mi Lee Sung Wook Hwang Sang Hyoung Park Dong-Hoon Yang Byong Duk Ye Jeong-Sik Byeon Seung-Jae Myung Suk-Kyun Yang |
| author_facet | Min Seob Kwak Kyung-Jo Kim Jae Hee Cheon Wan Soo Kim Jeong-Mi Lee Sung Wook Hwang Sang Hyoung Park Dong-Hoon Yang Byong Duk Ye Jeong-Sik Byeon Seung-Jae Myung Suk-Kyun Yang |
| author_sort | Min Seob Kwak |
| collection | DOAJ |
| description | Background. Although immunomodulators are increasingly used in Crohn’s disease (CD), a significant number of gastroenterologists still use 5-aminosalicylate (5-ASA) in combination with azathioprine (AZA) or 6-mercaptopurine (6-MP); there is limited evidence regarding the benefit of concomitant 5-ASA with AZA/6-MP compared with AZA/6-MP monotherapy for the treatment of CD. Study Design. A total of 106 patients who received AZA/6-MP for more than 3 months between January 1991 and May 2014 were identified retrospectively. Each patient was matched with 3 randomly selected controls who were treated with concomitant therapy during the same period. Results. The cumulative probabilities of steroid use at 5 and 10 years were 24.9% and 75.8% in the 5-ASA + AZA/6-MP group and 31.2% and 87.8% in the AZA/6-MP group, respectively (P=0.187). The cumulative probabilities of anti-TNF use, resectional surgery, and disease-related hospitalization were comparable between the groups. The younger age and the use of lower doses of immunomodulators were associated with higher requirement of rescue therapy. Conclusions. This study did not demonstrate that the concomitant use of 5-ASA with AZA/6-MP showed the proof or effect in terms of steroid requirements, anti-TNF use, resectional surgery, or disease-related hospitalization compared with that of AZA/6-MP alone. |
| format | Article |
| id | doaj-art-ead91f211cb1459cbcd9564f903b4cca |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-ead91f211cb1459cbcd9564f903b4cca2025-02-03T07:25:24ZengWileyGastroenterology Research and Practice1687-61211687-630X2018-01-01201810.1155/2018/48269734826973Comparison of Concomitant Mesalamine and Immunomodulator Therapy and Immunomodulator Monotherapy for Crohn’s DiseaseMin Seob Kwak0Kyung-Jo Kim1Jae Hee Cheon2Wan Soo Kim3Jeong-Mi Lee4Sung Wook Hwang5Sang Hyoung Park6Dong-Hoon Yang7Byong Duk Ye8Jeong-Sik Byeon9Seung-Jae Myung10Suk-Kyun Yang11Department of Internal Medicine, Kyung Hee University Hospital at Gang Dong, Kyung Hee University College of Medicine, Seoul, Republic of KoreaDepartment of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of KoreaDepartment of Internal Medicine, Graduate School, Yonsei University College of Medicine, Seoul, Republic of KoreaDepartment of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of KoreaDepartment of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of KoreaDepartment of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of KoreaDepartment of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of KoreaDepartment of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of KoreaDepartment of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of KoreaDepartment of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of KoreaDepartment of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of KoreaDepartment of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of KoreaBackground. Although immunomodulators are increasingly used in Crohn’s disease (CD), a significant number of gastroenterologists still use 5-aminosalicylate (5-ASA) in combination with azathioprine (AZA) or 6-mercaptopurine (6-MP); there is limited evidence regarding the benefit of concomitant 5-ASA with AZA/6-MP compared with AZA/6-MP monotherapy for the treatment of CD. Study Design. A total of 106 patients who received AZA/6-MP for more than 3 months between January 1991 and May 2014 were identified retrospectively. Each patient was matched with 3 randomly selected controls who were treated with concomitant therapy during the same period. Results. The cumulative probabilities of steroid use at 5 and 10 years were 24.9% and 75.8% in the 5-ASA + AZA/6-MP group and 31.2% and 87.8% in the AZA/6-MP group, respectively (P=0.187). The cumulative probabilities of anti-TNF use, resectional surgery, and disease-related hospitalization were comparable between the groups. The younger age and the use of lower doses of immunomodulators were associated with higher requirement of rescue therapy. Conclusions. This study did not demonstrate that the concomitant use of 5-ASA with AZA/6-MP showed the proof or effect in terms of steroid requirements, anti-TNF use, resectional surgery, or disease-related hospitalization compared with that of AZA/6-MP alone.http://dx.doi.org/10.1155/2018/4826973 |
| spellingShingle | Min Seob Kwak Kyung-Jo Kim Jae Hee Cheon Wan Soo Kim Jeong-Mi Lee Sung Wook Hwang Sang Hyoung Park Dong-Hoon Yang Byong Duk Ye Jeong-Sik Byeon Seung-Jae Myung Suk-Kyun Yang Comparison of Concomitant Mesalamine and Immunomodulator Therapy and Immunomodulator Monotherapy for Crohn’s Disease Gastroenterology Research and Practice |
| title | Comparison of Concomitant Mesalamine and Immunomodulator Therapy and Immunomodulator Monotherapy for Crohn’s Disease |
| title_full | Comparison of Concomitant Mesalamine and Immunomodulator Therapy and Immunomodulator Monotherapy for Crohn’s Disease |
| title_fullStr | Comparison of Concomitant Mesalamine and Immunomodulator Therapy and Immunomodulator Monotherapy for Crohn’s Disease |
| title_full_unstemmed | Comparison of Concomitant Mesalamine and Immunomodulator Therapy and Immunomodulator Monotherapy for Crohn’s Disease |
| title_short | Comparison of Concomitant Mesalamine and Immunomodulator Therapy and Immunomodulator Monotherapy for Crohn’s Disease |
| title_sort | comparison of concomitant mesalamine and immunomodulator therapy and immunomodulator monotherapy for crohn s disease |
| url | http://dx.doi.org/10.1155/2018/4826973 |
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