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Remission induction, maintenance, and endoscopic outcome with oral 5-aminosalicylic acid in intestinal Behçet's disease.

Authors
  • Kinoshita, Hiroto1, 2
  • Nishioka, Hitomi1
  • Ikeda, Aya1
  • Ikoma, Kyoko3
  • Sameshima, Yoichi3
  • Ohi, Hidehisa3
  • Tatsuno, Mizuki1
  • Kouyama, Junka1
  • Kawamoto, Chiaki1
  • Mitsui, Tomohiro1
  • Tamura, Yuko1
  • Hashimoto, Yu1
  • Nishio, Masashi1
  • Ogashiwa, Tsuyoshi1
  • Saigusa, Yusuke4
  • Maeda, Shin5
  • Kimura, Hideaki1
  • Kunisaki, Reiko1
  • Koike, Kazuhiko2
  • 1 Inflammatory Bowel Disease Center, Yokohama City University Medical Center, Yokohama, Japan. , (Japan)
  • 2 Department of Gastroenterology, The University of Tokyo, Tokyo, Japan. , (Japan)
  • 3 Department of Gastroenterology, Idzuro Imamura Hospital, Kagoshima, Japan. , (Japan)
  • 4 Department of Biostatistics, Yokohama City University Graduate School of Medicine, Yokohama, Japan. , (Japan)
  • 5 Department of Gastroenterology, Department of Medicine, Yokohama City University, Yokohama, Japan. , (Japan)
Type
Published Article
Journal
Journal of Gastroenterology and Hepatology
Publisher
Wiley (Blackwell Publishing)
Publication Date
Nov 01, 2019
Volume
34
Issue
11
Pages
1929–1939
Identifiers
DOI: 10.1111/jgh.14690
PMID: 31017728
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Oral 5-aminosalicylic acid (5-ASA) is recommended for the therapy of mild to moderate intestinal Behçet's disease (BD). However, the induction remission efficacy and endoscopic outcomes of 5-ASA are unknown. We investigated remission induction at 8 weeks, endoscopic outcomes until 52 weeks, and event-free survival at 52 weeks in patients with intestinal BD treated with 5-ASA. Forty-one patients with intestinal BD were treated with oral 5-ASA. Clinical remission was evaluated with the Crohn's disease activity index (CDAI). The endoscopic response was evaluated using the modified global gastrointestinal endoscopic assessment scores. Rescue therapy-free survival and surgery-free survival at 52 weeks were estimated, and predictive factors for a clinical response at weeks 8 and 52 were identified. Seven patients (17%) withdrew 5-ASA early (≤ 8 weeks) because of adverse events. At week 8, clinical efficacy could be accurately evaluated in 28 patients, and the response and remission rates were 61% and 57%, respectively, using the CDAI. Endoscopic evaluation was achieved in 17 patients up to 52 weeks, and the endoscopic response and remission rates were 71% and 35%, respectively. The probabilities of rescue therapy-free survival and surgery-free survival were 73% and 100%, respectively, at 52 weeks in all 41 patients. The predictive factors for therapeutic effectiveness at week 8 were a higher baseline C-reactive protein level and CDAI, but they were negative predictive factors for a 52-week response. 5-ASA is effective for clinical and endoscopic induction and maintaining a response in patients with mild to moderate intestinal BD. © 2019 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

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