Relationship between non-adherence to aminosalicylate medication and the risk of clinical relapse among Japanese patients with ulcerative colitis in clinical remission: a prospective cohort study

Kawakami, Aki; Tanaka, Makoto; Nishigaki, Masakazu; Iwao, Yasushi; Hibi, Toshifumi; Sanada, Hiromi; Yamamoto‐Mitani, Noriko; Kishi, Kazuma

doi:10.1007/s00535-012-0721-x

Cited by 34 publications

(33 citation statements)

References 40 publications

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“…In addition, Kawakami, et al reported twice higher risk for relapse in non-adherent patients than in adherent patients [17], suggesting relationship between reduced adherence and increased risk for relapse. Furthermore, as for the reasons for drug adherence, Kane, et al cited skipped doses (50%), the large number of tablets (30%), and no need felt (20%) [16], and Hawthorne, et al reported involvement of frequent dosing (3 times daily) [18].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, as for the reasons for drug adherence, Kane, et al cited skipped doses (50%), the large number of tablets (30%), and no need felt (20%) [16], and Hawthorne, et al reported involvement of frequent dosing (3 times daily) [18]. Meanwhile, the survey by Kawakami, et al reported extremely high adherence in Japanese UC patients [17], and the study by Watanabe, et al did not provide evidence for the effect of the number of doses [19]. As the reason for high adherence in Japanese patients, Japanese temperament and direct consultation with IBD expert as well as lack of financial concerns thanks to financial support system for UC patients (Research on Measures for Intractable Diseases) have been cited [17].…”

Section: Discussionmentioning

confidence: 99%

“…Meanwhile, the survey by Kawakami, et al reported extremely high adherence in Japanese UC patients [17], and the study by Watanabe, et al did not provide evidence for the effect of the number of doses [19]. As the reason for high adherence in Japanese patients, Japanese temperament and direct consultation with IBD expert as well as lack of financial concerns thanks to financial support system for UC patients (Research on Measures for Intractable Diseases) have been cited [17]. …”

Section: Discussionmentioning

confidence: 99%

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Real life results in using 5-ASA for maintaining mild to moderate UC patients in Japan, a multi-center study, OPTIMUM Study

et al. 2017

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BackgroundEfficacy of maintenance therapy in ulcerative colitis (UC) in the remission stage has been reported to depend on release profile or dosing regimen of oral 5-aminosalicylic acid (5-ASA) products used. Aim of this study is to investigate real life results in using oral 5-ASA products for maintaining mild to moderate UC patients in Japan.MethodsAdult UC outpatients treated with oral 5-ASA products were enrolled from 379 sites in Japan between July 2012 and July 2013, and followed for 52 weeks. Remission maintenance rate was evaluated by products and dosages. Factors affecting recurrence were also examined.ResultsA total of 5695 UC patients were registered. Among the 4677 patients in whom remission maintenance was observed, remission maintenance rate at week 52 was 80.2%. As for disease duration and dosage, Pentasa® 4000 mg/day in 2 divided doses was administered to 480 (21.0%) patients in remission and 341 (46.6%) patients in active stage, and Asacol® 3600 mg/day in 3 divided doses was administered to 696 (46.4%) patients in remission and 473 (67.3%) patients in active stage.The remission maintenance rate at week 52 by dosage and frequency did not significantly differ between Pentasa® Tablets at 4000 mg/day in 2 divided doses (76.5%) and Asacol® Tablets at 3600 mg/day in 3 divided doses (76.1%, P = 0.7868).Factors affecting the risk of relapse in UC were identified. Significantly persistent remission maintenance was noted in patients in whom duration of remission maintenance until enrollment was 12 to <24 months or ≥24 months relative to the reference category of <3 months (12 to <24 months: HR 0.600 [0.486–0.740], p < 0.0001]; ≥24 months: HR 0.352 [0.289–0.431], p < 0.0001).ConclusionsEfficacy of real life results in using oral 5-ASA products for maintaining mild to moderate UC patients was favorable. Maintaining remission for 12 months or longer after induction therapy was shown to reduce recurrence risk thereafter.Trial registration UMIN 000008563 (the date of registration: July 30, 2012), ClinicalTrials.gov NCT01654783 (the date of registration: July 30, 2012)Electronic supplementary materialThe online version of this article (doi:10.1186/s12876-017-0604-y) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Real life results in using 5-ASA for maintaining mild to moderate UC patients in Japan, a multi-center study, OPTIMUM Study

et al. 2017

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“…The adherence in this study was higher than that noted in Western studies whose non-adherence rate ranged between 30 and 45%. Even in Japanese patients with UC who have extremely high adherence, a twofold higher risk for relapse was reported in non-adherent patients than in adherent patients [3]. Therefore, the improvement of adherence by means of 5-ASA granules should reduce clinical relapse; however, further studies will be necessary to validate this theory.…”

Section: Discussionmentioning

confidence: 96%

“…Non-adherence to 5-aminosalicylic acid (5-ASA) has been reported to increase the risk of clinical relapse in ulcerative colitis (UC) [1][2][3]. Additionally, continued use of 5-ASA may reduce the risk of colorectal cancer development in patients with UC [4].…”

Section: Introductionmentioning

confidence: 99%

Treatment Adherence in Patients with Ulcerative Colitis Is Dependent on the Formulation of 5-Aminosalicylic Acid

Nakagawa¹,

Okaniwa²,

Mizuno³

et al. 2018

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Background/Aims: It is unclear whether 5-aminosalicylic acid (5-ASA) formulation is associated with treatment adherence in ulcerative colitis (UC). Thus, we aimed to investigate the adherence rate after switching from 5-ASA tablets to granules. Methods: This prospective study included 121 UC outpatients treated using 5-ASA tablets. They were grouped based on choice: Group 1 (continued with tablets) and Group 2 (switched to granules without regimen change). Group 2 was further divided into Group 3 (returned to tablets) and Group 4 (continued with granules). The patients completed a self-administered questionnaire regarding the treatment. The primary endpoint was change in adherence after switching to granules. Results: Seventy-nine patients continued with tablets, while 42 patients switched to granules. The adherence rate to the tablet was not significantly different between Group 1 and 2 before switching. In Group 2, switching to granules did not affect adherence. However, in Group 4, adherence significantly improved after switching to granules. Group 3 showed no significant change in adherence before and after switching from tablets. Full-time work and difficulty taking tablets were significant predictors of continuing with granules in Group 4. Conclusion: Patients who continued with 5-ASA granules showed significantly increased adherence, suggesting that patient-tailored drug formulations improved treatment adherence.

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Questionnaire survey to identify meal habits which influence adherence to oral 5‐aminosalicylic acid regimens in patients with ulcerative colitis

Suzuki

Fujii

Yamauchi

et al. 2021

Pharmacy Practice and Res

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Aim: Patient adherence to oral 5-aminosalicylic acid (5-ASA) therapy is key for the induction and maintenance of remission in ulcerative colitis (UC). We conducted a questionnaire survey of meal habits among patients with UC to determine which meal habits influence adherence to oral 5-ASA regimens. Methods: The anonymous questionnaire, including information on basic demographics, disease status, 5-ASA use, and patient lifestyle, was given to outpatients receiving oral 5-ASA for UC between January 2019 and April 2019 at Gifu University Hospital. Results: A total of 101 patients replied to the questionnaire. Multivariate logistic regression analysis indicated that "Often skipping a meal" and "Multiple dose regimen" were factors in decreased adherence (<80%) to oral 5-ASA medications. Among patients taking a multi-daily dose, the rate of patients with ≥80% adherence to oral 5-ASA medications replying to "Often skipping a meal" was significantly lower than in patients replying to "Three meals per day (Not skipping a meal)" (53.8% vs 81.3%. p = 0.032), although these differences were not found among patients taking a once-daily dose (80.0% vs 100%. p = 0.529). Conclusion: These findings identify "Often skipping a meal" and "Multiple dose regimen" as factors associated with decreased adherence to oral 5-ASA. Adherence to oral 5-ASA in patients skipping a meal may be improved by adoption of a once-daily dose regimen.

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Relationship between non-adherence to aminosalicylate medication and the risk of clinical relapse among Japanese patients with ulcerative colitis in clinical remission: a prospective cohort study

Cited by 34 publications

References 40 publications

Real life results in using 5-ASA for maintaining mild to moderate UC patients in Japan, a multi-center study, OPTIMUM Study

Real life results in using 5-ASA for maintaining mild to moderate UC patients in Japan, a multi-center study, OPTIMUM Study

Treatment Adherence in Patients with Ulcerative Colitis Is Dependent on the Formulation of 5-Aminosalicylic Acid

Questionnaire survey to identify meal habits which influence adherence to oral 5‐aminosalicylic acid regimens in patients with ulcerative colitis

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