Optimised mesalazine therapy reduces ulcerative colitis recurrence across the mild-to-moderate disease spectrum: the...

Area of Science:

• Gastroenterology
• Pharmacology
• Clinical Medicine

Background:

• Optimised oral mesalazine therapy (4 or 4.8 g/day) shows improved outcomes in mild-to-moderate ulcerative colitis (UC).
• Understanding the influence of disease severity on outcomes with oral mesalazine is crucial for treatment optimization.

Purpose of the Study:

• To analyze the IMPACT study data to understand how disease severity affects outcomes in mild-to-moderate UC patients treated with oral mesalazine.
• To compare outcomes between patients receiving 4 g/day versus 2-3 g/day of oral mesalazine.

Main Methods:

• Post-hoc analysis of the 12-month, prospective, observational IMPACT study (NCT02261636).
• 151 adult patients with mild-to-moderate UC received oral prolonged-release mesalazine.
• Comparison of outcomes between mesalazine 4 g/day and 2-3 g/day groups.

Main Results:

• Recurrence was significantly lower in the 4 g/day group (26.6%) compared to the 2-3 g/day group (62.5%, p=0.03).
• A trend towards a longer disease-free interval was observed with the 4 g/day dose (16.8 vs. 12.8 months, p=0.49).
• Time to recurrence was similar across disease severities (mild vs. moderate), with higher combined therapy use in moderate cases (46.1%).

Conclusions:

• Optimised mesalazine treatment (4 g/day) improved clinical outcomes in patients with mild-to-moderate UC.
• The 4 g/day dose demonstrated a significant reduction in recurrence rates.
• Mesalazine therapy was effective across the spectrum of mild-to-moderate UC disease severity.