Mesalamine Enemas for Induction of Remission in Oral Mesalamine-refractory Pediatric Ulcerative Colitis : A Prospective Cohort Study

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Levine , A , Yerushalmi , B , Kori , M , Broide , E , Mozer-Glassberg , Y , Shaoul , R , Kolho , K-L , Shteyer , E , Shamaly , H , Ledder , O , Cohen , S , Peleg , S , Shabat , C S , Focht , G , Shachmon , E , Boaz , M , On , A & Turner , D 2017 , ' Mesalamine Enemas for Induction of Remission in Oral Mesalamine-refractory Pediatric Ulcerative Colitis : A Prospective Cohort Study ' , Journal of Crohn's and Colitis , vol. 11 , no. 8 , pp. 970-974 . https://doi.org/10.1093/ecco-jcc/jjx042

Title: Mesalamine Enemas for Induction of Remission in Oral Mesalamine-refractory Pediatric Ulcerative Colitis : A Prospective Cohort Study
Author: Levine, Arie; Yerushalmi, Baruch; Kori, Michal; Broide, Efrat; Mozer-Glassberg, Yael; Shaoul, Ron; Kolho, Kaija-Leena; Shteyer, Eyal; Shamaly, Hussein; Ledder, Oren; Cohen, Shlomi; Peleg, Sarit; Shabat, Chen Sarbagili; Focht, Gili; Shachmon, Ebby; Boaz, Mona; On, Avi; Turner, Dan
Contributor: University of Helsinki, Clinicum
Date: 2017-08
Language: eng
Number of pages: 5
Belongs to series: Journal of Crohn's and Colitis
ISSN: 1873-9946
URI: http://hdl.handle.net/10138/297908
Abstract: Background: Paediatric ulcerative colitis [UC] is more extensive than adult disease, and more often refractory to mesalamine. However, no prospective trials have evaluated mesalamine enemas for inducing remission in children. Our goal was to evaluate the ability of mesalamine enemas to induce remission in mild to moderate paediatric UC refractory to oral mesalamine. Methods: This was an open-label arm of a previously reported randomised controlled trial of once-daily mesalamine in active paediatric UC [MUPPIT trial]. Children aged 4-18 years, with a Paediatric Ulcerative Colitis Activity Index [PUCAI] score of 10-55, were enrolled after failing at least 3 weeks of full-dose oral mesalamine. Patients treated with steroids or enemas in the previous month and those with isolated proctitis were excluded. Children received Pentasa (R) enemas 25 mg/kg [up to 1g] daily for 3 weeks with the previous oral dose. The primary endpoint was clinical remission by Week 3. Results: A total of 38 children were enrolled (mean age 14.6 +/- 2.3 years; 17/38 [45%] with extensive colitis). Clinical remission was obtained in 16 [42%] and response was obtained in 27 [71%] at Week 3. Eight children deteriorated and required steroids. There were no differences in baseline parameters between those who entered or failed to enter remission, including disease extent [43% in left-sided and 41% in extensive colitis] and disease activity [44% in mild and 41% in moderate activity]. Conclusion: Clinical remission can be markedly increased in children who are refractory to oral mesalamaine by adding mesalamine enemas for 3 weeks, before commencing steroids.
Subject: Drugs
ulcerative colitis
child
EVIDENCE-BASED CONSENSUS
QUALITY-OF-LIFE
ACTIVITY INDEX
DOUBLE-BLIND
MESALAZINE
CHILDREN
PROCTITIS
EFFICACY
THERAPY
METAANALYSIS
3121 General medicine, internal medicine and other clinical medicine
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