The gap between scientific evidence and clinical practice: 5‐aminosalicylates are frequently used for the treatment of Crohn's disease

Schoepfer, Alain; Bortolotti, M.; Pittet, Valérie; Mottet, Christian; Gonvers, Jean‐Jacques; Reich, Oliver; Fournier, Nicolas; Vader, John‐Paul; Burnand, Bernard; Michetti, Pierre; Froehlich, Florian

doi:10.1111/apt.12929

Cited by 45 publications

(47 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…12 Whether this represents a true drug effect or simply a biased patient selection with a priori benign natural course of CD is debatable, as it is known that Crohn's colitis can remain uncomplicated for many years in the adult population. 24 In pediatric CD the disease course in general is less benign.…”

Section: -Asa In CDmentioning

confidence: 99%

“…11 Despite the controversy and lack of evidence for therapeutic benefit many CD patients undergo 5-ASA treatment during their disease course. 12 The likelihood of having used 5-ASA appears to be associated with longer disease duration and colonic location at CD diagnosis. 12 There are no data available about topical 5-ASA therapy in colonic CD.…”

mentioning

confidence: 98%

“…12 The likelihood of having used 5-ASA appears to be associated with longer disease duration and colonic location at CD diagnosis. 12 There are no data available about topical 5-ASA therapy in colonic CD.…”

mentioning

confidence: 98%

See 2 more Smart Citations

The Use of 5-Aminosalicylic Acid in Children and Adolescents With Inflammatory Bowel Disease

Sokollik

Fournier

Rizzuti

et al. 2018

Journal of Clinical Gastroenterology

View full text Add to dashboard Cite

Background: In ulcerative colitis (UC) 5-aminosalicylic acid (5-ASA) is recommended as primary therapy for mild to moderate disease. Topical 5-ASA has been proven especially effective. In Crohn’s disease (CD) the evidence for a beneficial role of 5-ASA is weak. We investigated the use of topical and systemic 5-ASA therapy in children and adolescents with inflammatory bowel disease. Materials and Methods: Data of patients younger than 18 years, registered between April 2008 and December 2015 in the Swiss Inflammatory Bowel Disease Cohort, were analyzed. Results: Three hundred twenty pediatric inflammatory bowel disease patients were included; 189 with CD and 131 with UC. Over one third of UC patients [51 (39%)] received topical 5-ASA therapy and 43 (33%) received combination therapy during their disease course. UC patients with left-sided colitis or proctitis were more likely to receive topical or combination therapy as compared with patients with pancolitis (P<0.001 and <0.001, respectively). An increase in the use of topical 5-ASA therapy in UC patients was noted over time from 5% to 38%. Forty-seven percent of CD patients were treated with oral 5-ASA during their disease course. The usage was stable over time at approximately 15% to 20%. Conclusions: In recent years a very positive trend showing an increase in topical 5-ASA therapy in children and adolescents with UC has been observed. However topical therapy is still used with relative low frequency, especially in patients with a more extensive disease. Conversely, despite weak evidence supporting 5-ASA use in CD patients it has been frequently prescribed. Physicians should continue to encourage their UC patients to use topical therapy.

show abstract

Section: -Asa In CDmentioning

confidence: 99%

mentioning

confidence: 98%

See 1 more Smart Citation

The Use of 5-Aminosalicylic Acid in Children and Adolescents With Inflammatory Bowel Disease

Sokollik

Fournier

Rizzuti

et al. 2018

Journal of Clinical Gastroenterology

View full text Add to dashboard Cite

show abstract

“…66 Despite a lack of evidence for their efficacy in CD treatment, they are often prescribed as adjuvant therapy due to minimal side effects, low cost and chemo-preventative properties. 3,67 Sulphasalazine or salicylazosulphapyridine [SASP] was originally developed for rheumatoid arthritis and contains 5-aminosalicyclate [5-ASA] bound to sulphapyridine 68 . Sulphapyridine exhibits direct antimicrobial activity and treatments with sulphapyridine have been linked to alterations in faecal bacterial profiles.…”

Section: Autophagy and Crohn’s Diseasementioning

confidence: 99%

Inflammatory Bowel Disease Drugs: A Focus on Autophagy

Hooper

Barlow

Stevens

et al. 2016

ECCOJC

View full text Add to dashboard Cite

Inflammatory bowel disease [IBD] is characterized by chronic inflammation of the gastrointestinal tract. Medications such as corticosteroids, thiopurines, immunomodulators and biologic agents are used to induce and maintain remission; however, response to these drugs is variable and can diminish over time. Defective autophagy has been strongly linked to IBD pathogenesis, with evidence showing that enhancing autophagy may be therapeutically beneficial by regulating inflammation and clearing intestinal pathogens. It is plausible that the therapeutic effects of some IBD drugs are mediated in part through modulation of the autophagy pathway, with studies investigating a wide range of diseases and cell types demonstrating autophagy pathway regulation by these agents. This review will highlight the current evidence, both in vitro and in vivo, for the modulation of autophagy by drugs routinely used in IBD. A clearer understanding of their mechanisms of action will be invaluable to utilize these drugs in a more targeted and personalized manner in this diverse and often complex group of patients.

show abstract

“…In a meta-analysis of CD patients in remission, neither sulfasalazine nor mesalamine were effective in preventing relapse in patients with quiescent CD, but in a per protocol analysis, mesalamine appeared to reduce risk of relapse (RR=0.79; 95 % CI=0.66-0.95, NNT=13) [68]. Nevertheless, prescribing patterns reveal that a large number of physicians and gastroenterologists worldwide continue to use aminosalicylates in the treatment of CD both for induction and maintenance of remission [69,92,93].…”

Section: Azathioprine and Other Immunosuppressants May Induce Remissimentioning

confidence: 99%

Indian Society of Gastroenterology consensus statements on Crohn’s disease in India

Ramakrishna

Makharia

Ahuja

et al. 2015

Indian J Gastroenterol

View full text Add to dashboard Cite

In 2012, the Indian Society of Gastroenterology's Task Force on Inflammatory Bowel Diseases undertook an exercise to produce consensus statements on Crohn's disease (CD). This consensus, produced through a modified Delphi process, reflects our current recommendations for the diagnosis and management of CD in India. The consensus statements are intended to serve as a reference point for teaching, clinical practice, and research in India.

show abstract

The gap between scientific evidence and clinical practice: 5‐aminosalicylates are frequently used for the treatment of Crohn's disease

Abstract: SUMMARY BackgroundThere is uncertain evidence of effectiveness of 5-aminosalicylates (5-ASA) to induce and maintain response and remission of active Crohn's disease (CD), and weak evidence to support their use in post-operative CD.

Cited by 45 publications

References 23 publications

The Use of 5-Aminosalicylic Acid in Children and Adolescents With Inflammatory Bowel Disease

The Use of 5-Aminosalicylic Acid in Children and Adolescents With Inflammatory Bowel Disease

Inflammatory Bowel Disease Drugs: A Focus on Autophagy

Indian Society of Gastroenterology consensus statements on Crohn’s disease in India

Contact Info

Product

Resources

About