title: Intermittent versus every-day mesalazine therapy in preventing complications of diverticular disease: a long-term follow-up study.
abstract: BACKGROUND
  Mesalazine seems to be effective in preventing recurrence of acute uncomplicated diverticulitis (AUD), but the optimal mesalazine scheme to achieve these results is still debated.
  
  
  OBJECTIVE
  To assess the effectiveness of two different mesalazine-based treatments in preventing recurrence of AUD and the occurrence of other complications of diverticular disease (DD) during a long-term follow-up.
  
  
  METHODS
  We reviewed 311 patients suffer from recent episode of AUD and undergoing to mesalazine treatment: 207 (group A, 105 males, median age 63 years, range 47-74 years) were treated with mesalazine 1.6 g for 10 days each month, whilst 104 (group B, 55 males, median age 65 years, range 50-72 years) were treated with mesalazine 1.6 g every day. Patients were followed-up every 6 months (median 7.5 months, range 5-13 months).
  
  
  RESULTS
  Patients were followed-up for a mean time of 3 years (range 12-72 months). Overall, occurrence of complication recurred more frequently in group A than in group B (p = 0.030, log-rank test). Acute diverticulitis recurred in 17 (8.2%) patients in group A and in 3 (2.9%) in group B; diverticular bleeding occurred in 4 (1.9%) patients in group A and in 1 (0.96%) patient in group B; surgery was required in 3 (1.4%) patients in group A and in no (0%) patient in group B.
  
  
  CONCLUSIONS
  This is the first study showing that long-term mesalazine treatment is significantly better that intermittent mesalazine treatment in preventing occurrence of DD complications after an attack of acute diverticulitis.
authors: Gastroenterology Service, ASL BAT, Andria (Barletta), Italy. antotursi@tiscali.it.
authors: A
authors: A
authors: Tursi
authors: F
authors: F
authors: Di Mario
authors: G
authors: G
authors: Brandimarte
authors: W
authors: W
authors: Elisei
authors: M
authors: M
authors: Picchio
authors: S
authors: S
authors: Loperfido
authors: N
authors: N
authors: Dal Bo'
authors: F
authors: F
authors: Ferrara
authors: R
authors: R
authors: Marcello
authors: H
authors: H
authors: Heras Salvat
authors: C
authors: C
authors: Scarpignato
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage* / Q000009:adverse effects; D016009:Chi-Square Distribution; D004239:Diverticulitis, Colonic / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D043963:Diverticulosis, Colonic / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D004241:Diverticulum, Colon / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D005765:Gastrointestinal Agents / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D019804:Mesalamine / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D012189:Retrospective Studies; D055502:Secondary Prevention; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D005765:Gastrointestinal Agents; D019804:Mesalamine