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Multi Matrix System Mesalazine Plus Rectal Mesalazine in the Treatment of Mild to Moderately Active Ulcerative
Antonio Cuomo1, Dolores Sgambato2, Mauro Valeriano D'Auria1
1Gastroenterology Unit "Umberto I" Hospital, Nocera Inferiore, Salerno, Italy.
Background:
Mesalazine 1 g suppository/die is used for mild to moderately active ulcerative proctitis (UP). Whether addiction of Multi Matrix System (MMX) mesalazine increases the remission rate of UP and prevents proximal extension of disease is unknown.
Methods:
This is a retrospective study on 116 outpatients with UP who had been treated with one of the following regimens: (1) MMX mesalazine 1.2 g/die plus mesalazine suppositories for 8 ± 2 weeks and, subsequently, MMX mesalazine 1.2 g/die plus rectal mesalazine 1 g every other day for at least 6 months; (2) mesalazine 1 g suppositories/die alone for 8 ± 2 weeks and, subsequently, rectal mesalazine 1 g every other day for 6 more months. Patients were evaluated clinically at 2 months (±2 weeks) and endoscopically at 6 months (±2 weeks). For categorical variables, Pearson chi-square test was used.
Results:
A total of 46 of 55 patients (84%) on combined therapy and 49 of 61 patients (80%) on rectal mesalazine reached clinical remission (p > 0.05; OR 0.79, 95% CI 0.30-2.07). At 6 months follow-up, proximal extension of disease was observed in 7 of 55 (14%) patients on combined therapy and in 18 of 61 (29%) patients on rectal mesalazine alone (p < 0.05; OR 2.87, 95% CI 1.09-7.53).
Conclusions:
Oral MMX mesalazine plus rectal mesalazine combined treatment is associated with prevention of proximal extension of the disease compared with rectal mesalazine alone.
Insights
Adding Multi Matrix System (MMX) mesalazine to rectal mesalazine therapy for ulcerative proctitis (UP) did not improve clinical remission rates. However, combined therapy effectively prevented the proximal extension of UP compared to rectal mesalazine alone.
Area of Science:
- Gastroenterology
- Inflammatory Bowel Disease
- Pharmacology
Background:
- Ulcerative proctitis (UP) is often treated with mesalazine suppositories.
- The efficacy of adding Multi Matrix System (MMX) mesalazine to standard therapy for UP is not well-established.
- Investigating the impact on remission rates and disease progression is crucial.
Purpose of the Study:
- To evaluate if adding MMX mesalazine to rectal mesalazine improves remission rates in UP.
- To determine if combined therapy prevents the proximal extension of ulcerative proctitis.
- To compare the outcomes of combined therapy versus rectal mesalazine alone.
Main Methods:
- Retrospective analysis of 116 outpatients with UP.
- Two treatment groups: (1) MMX mesalazine plus rectal mesalazine, (2) rectal mesalazine alone.
- Clinical evaluation at 2 months and endoscopic evaluation at 6 months.
Main Results:
- Clinical remission rates were similar between groups (84% vs. 80%, p > 0.05).
- Proximal disease extension was significantly lower in the combined therapy group (14% vs. 29%, p < 0.05).
- Combined therapy showed a significant protective effect against disease extension (OR 2.87).
Conclusions:
- Combined oral MMX mesalazine and rectal mesalazine therapy is effective in preventing proximal extension of UP.
- While not improving remission rates, the combination offers a benefit in disease containment.
- This suggests a role for combined therapy in managing ulcerative proctitis progression.
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