title: High mucosal healing rates in 5-ASA-treated ulcerative colitis patients: results of a meta-analysis of clinical trials.
abstract: BACKGROUND
  Recently, mucosal healing (MH) is regarded as an important treatment goal in ulcerative colitis (UC). 5-Aminosalicylates (5-ASA) are the standard treatment in mild-to-moderate UC, but the effect on MH is less known. The aim of this study was to systematically review the medical literature in order to compare different preparations of 5-ASA for the effect on MH.
  
  
  METHODS
  We conducted a structured search of PubMed and the Cochrane Central Register of Controlled Trials to identify randomized controlled clinical trials with 5-ASA in UC providing data about MH. We calculated the sample size-weighted pooled proportion of patients with MH, and performed meta-analysis of head-to-head comparisons.
  
  
  RESULTS
  Out of 645 hits, we included 90 treatment arms, involving 3977 patients using oral 5-ASA (granulate and tablets) and 2513 patients using rectal 5-ASA (suppositories, enema, and foam). Overall, 43,7% of 5-ASA treated patients achieved MH (oral 36,9%; rectal 50,3%). In oral studies, 49% of patients using granulate (7 treatment-arms) achieved MH compared to 34,9% using tablets (43 treatment-arms). In rectal studies the proportion of MH was 62% for suppositories (eight treatment arms), 51% for foam (nine treatment arms), and 46% for enema (23 treatment arms), respectively.
  
  
  CONCLUSIONS
  5-ASA preparations achieved MH in nearly 50% of UC patients. There were no significant differences in MH between the various 5-ASA agents, either in the oral or the rectal treatment groups.
authors.affiliation: Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. t.romkens@mdl.umcn.nl
authors.forename: Tessa E H
authors.initials: TE
authors.lastname: Römkens
authors.forename: Milou T
authors.initials: MT
authors.lastname: Kampschreur
authors.forename: Joost P H
authors.initials: JP
authors.lastname: Drenth
authors.forename: Martijn G H
authors.initials: MG
authors.lastname: van Oijen
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: de Jong
mesh_terms: D002986:Clinical Trials as Topic; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D006801:Humans; D007413:Intestinal Mucosa / Q000187:drug effects* / Q000473:pathology; D019804:Mesalamine / Q000627:therapeutic use*; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D019804:Mesalamine