Efficacy of 5-ASA in the treatment of colonic diverticular disease.
OBJECTIVE
To assess the therapeutic efficacy of 5-aminosalicylic acid (5-ASA) in patients with colonic diverticular disease performing a systematic review of the literature.


METHODS
Cochrane Trial Register (until Issue 4, 2008), Medical Literature Analysis and Retrieval System Online (1966 to October 1, 2008), Excerpta Medica Database (1980 to October 1, 2008), and abstracts from the major US, European, and Asian gastroenterology conferences. Expert opinions sought and reference lists of identified studies and any relevant published reviews checked.


METHODS
Randomized controlled trial (RCT) or a controlled clinical trial with a parallel group design using 5-ASA as 1 treatment arm.


RESULTS
Six RCTs enrolling 818 patients were found: 3 were performed in patients with uncomplicated diverticulitis, and the remaining in patients with symptomatic uncomplicated diverticular disease. The results of these studies showed that patients treated with 5-ASA had significantly better outcomes and that also mesalazine scheduled daily was superior to cyclic administration to prevent relapse of diverticular disease. However, several of these studies have not included an endoscopy at the start of the study and when patients had recurrences.


CONCLUSIONS
From this systematic review, it seems that 5-ASAs may have a role in patients with colonic diverticular disease. However, high-quality well-designed RCTs are necessary to confirm these initial observations.
Gatta
Luigi
L
Versilia Hospital, Lido di Camaiore, Department of Clinical Science, University of Parma, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. gattaluigi@yahoo.it
Vakil
Nimish
N
Vaira
Dino
D
Pilotto
Alberto
A
Curlo
Margherita
M
Comparato
Giuseppe
G
Leandro
Gioacchino
G
Ferro
Umberto
U
Lera
Maurizio
M
Milletti
Sergio
S
Di Mario
Francesco
F
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D004239:Diverticulitis, Colonic / Q000188:drug therapy* / Q000503:physiopathology; D004334:Drug Administration Schedule; D006801:Humans; D019804:Mesalamine / Q000008:administration & dosage / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D055502:Secondary Prevention; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D019804:Mesalamine