title: Oral mesalazine (5-ASA) treatment may protect against proximal extension of mucosal inflammation in ulcerative proctitis.
abstract: OBJECTIVE
  Studies aimed at establishing which characteristics of patients with ulcerative proctitis could be predictive of the extension of inflammation have failed to provide conclusive results. The aim of the study was to evaluate the prognostic role of clinical and therapeutic parameters in patients with proctitis.
  
  
  METHODS
  Case records of 138 patients with ulcerative proctitis were retrospectively evaluated. The following parameters were considered: gender; age at onset of disease; smoking habits; histologic severity of disease at onset; mean number of clinical relapses of disease per year; mean duration of oral and topical mesalazine treatment; and number of topical corticosteroid treatments per year.
  
  
  RESULTS
  Twenty-eight patients were excluded from the analysis for different reasons. During follow-up, inflammation spread proximally in 33 of 110 patients (30%). Patients with extended proctitis showed a significantly higher number of relapses and a shorter duration of oral mesalazine treatment than patients with nonprogressive proctitis (p < 0.001 for both). The multivariate analysis also found that the mean duration of topical mesalazine treatment was longer in patients with extended proctitis.
  
  
  CONCLUSIONS
  Ulcerative proctitis patients with more frequent relapses who need a longer duration of topical therapy are at higher risk of extension of the disease, while a more prolonged oral mesalazine treatment period protects against the proximal spread of rectal inflammation.
authors.affiliation: Gastrointestinal Unit, Department of Clinical Sciences, La Sapienza University, Rome, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Pica
authors.forename: Omero Alessandro
authors.initials: OA
authors.lastname: Paoluzi
authors.forename: Federico
authors.initials: F
authors.lastname: Iacopini
authors.forename: Adriana
authors.initials: A
authors.lastname: Marcheggiano
authors.forename: Pietro
authors.initials: P
authors.lastname: Crispino
authors.forename: Margherita
authors.initials: M
authors.lastname: Rivera
authors.forename: Antonino
authors.initials: A
authors.lastname: Bella
authors.forename: Adriana
authors.initials: A
authors.lastname: Consolazio
authors.forename: Paolo
authors.initials: P
authors.lastname: Paoluzi
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D003093:Colitis, Ulcerative / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008499:Medical Records; D019804:Mesalamine / Q000008:administration & dosage / Q000627:therapeutic use*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D019804:Mesalamine