title: Prophylactic mesalamine treatment decreases postoperative recurrence of Crohn's disease.
abstract: OBJECTIVE
  Recurrence of Crohn's disease frequently occurs after surgery. A randomized controlled trial was performed to determine if mesalamine is effective in decreasing the risk of recurrent Crohn's disease after surgical resection is performed.
  
  
  METHODS
  One hundred sixty-three patients who underwent a surgical resection and had no evidence of residual disease were randomized to a treatment group (1.5 g mesalamine twice a day) or a placebo control group within 8 weeks of surgery. The follow-up period was a maximum of 72 months.
  
  
  RESULTS
  The symptomatic recurrence rate (symptoms plus endoscopic and/or radiological confirmation of disease) in the treatment group was 31% (27 of 87) compared with 41% (31 of 76) in the control group (P = 0.031). The relative risk of developing recurrent disease was 0.628 (90% confidence interval, 0.40-0.97) for those in the treatment group (P = 0.039; one-tail test) using an intention-to-treat analysis and 0.532 (90% confidence interval, 0.32-0.87) using an efficacy analysis. The endoscopic and radiological rate of recurrence was also significantly decreased with relative risks of 0.654 (90% confidence interval, 0.47-0.91) in the effectiveness analysis and 0.635 (90% confidence interval, 0.44-0.91) in the efficacy analysis. There was only one serious side effect (pancreatitis) in subjects in the treatment group.
  
  
  CONCLUSIONS
  Mesalamine (3.0 g/day) is effective in decreasing the risk of recurrence of Crohn's disease after surgical resection is performed.
authors.affiliation: Department of Surgery, University of Toronto, Ontario, Canada.
authors.forename: R S
authors.initials: RS
authors.lastname: McLeod
authors.forename: B G
authors.initials: BG
authors.lastname: Wolff
authors.forename: A H
authors.initials: AH
authors.lastname: Steinhart
authors.forename: P W
authors.initials: PW
authors.lastname: Carryer
authors.forename: K
authors.initials: K
authors.lastname: O'Rourke
authors.forename: D F
authors.initials: DF
authors.lastname: Andrews
authors.forename: J E
authors.initials: JE
authors.lastname: Blair
authors.forename: J R
authors.initials: JR
authors.lastname: Cangemi
authors.forename: Z
authors.initials: Z
authors.lastname: Cohen
authors.forename: J B
authors.initials: JB
authors.lastname: Cullen
mesh_terms: D000328:Adult; D000636:Aminosalicylic Acids / Q000009:adverse effects / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D016001:Confidence Intervals; D003424:Crohn Disease / Q000517:prevention & control / Q000601:surgery*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019804:Mesalamine; D010195:Pancreatitis / Q000139:chemically induced; D010349:Patient Compliance; D012008:Recurrence; D012307:Risk Factors
chemical_list: D000636:Aminosalicylic Acids; D000894:Anti-Inflammatory Agents, Non-Steroidal; D019804:Mesalamine