title: Efficacy of long-term 4.0 g/day mesalazine (Pentasa) for maintenance therapy in ulcerative colitis.
abstract: BACKGROUND
  High-dose (4.0 g/day) mesalazine is typically used for induction therapy, but its efficacy as maintenance therapy remains to be determined. We conducted a multicenter retrospective study to investigate the efficacy of continuous treatment with 4.0 g/day of mesalazine.
  
  
  METHODS
  Japanese ulcerative colitis (UC) patients receiving acute induction therapy with 4.0 g/day mesalazine were enrolled and followed. Those who clinically improved or who achieved clinical remission were categorized into 2 sub-groups according to the median duration of treatment with 4.0 g/day of mesalazine. The clinical relapse frequency and the time to relapse were analyzed.
  
  
  RESULTS
  We enrolled 180 patients with active UC, and then 115 patients who clinically improved or who achieved clinical remission after treatment with 4.0 g/day mesalazine were categorized into 2 sub-groups according to the median of treatment duration: a short-term treatment group (≤105 days, n=58) and a long-term treatment group (>105 days, n=57). Overall, 45 (39.1%) patients relapsed: 28 (48.3%) in the short-term treatment group and 17 (29.8%) in the long-term treatment group. This difference was statistically significant (p<0.05). The relapse-free rate in the long-term treatment group was significantly higher than that in the short-term treatment group (p<0.05). The mean time to relapse in the long-term treatment group was significantly longer than that in the short-term treatment group (425.6±243.8 days vs. 277.4±224.5 days; p<0.05).
  
  
  CONCLUSIONS
  Long-term continuous treatment with high-dose mesalazine (4.0 g/day) may be more effective than short-term treatment for maintenance of remission in UC patients.
authors: Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors: Fuminao
authors: F
authors: Takeshima
authors: Department of Gastroenterology and Hepatology, Matsumura Clinic, Sasebo, Japan.
authors: Masato
authors: M
authors: Matsumura
authors: Gastroenterology Unit, Shunkaikai Medical Corporation Inoue Hospital, Nagasaki, Japan.
authors: Kazuya
authors: K
authors: Makiyama
authors: Department of Internal Medicine, Isahaya Health Insurance General Hospital, Isahaya, Japan.
authors: Kazuo
authors: K
authors: Ohba
authors: Department of Internal Medicine, Nagasaki Municipal Medical Center, Nagasaki, Japan.
authors: Masaki
authors: M
authors: Yamakawa
authors: Department of Gastroenterology, National Hospital Organization Nagasaki Medical Center, Ohmura, Japan.
authors: Hitoshi
authors: H
authors: Nishiyama
authors: Department of Gastroenterology and Hepatology, Sasebo City General Hospital, Sasebo, Japan.
authors: Takuji
authors: T
authors: Yamao
authors: Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors: Yuko
authors: Y
authors: Akazawa
authors: Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors: Naoyuki
authors: N
authors: Yamaguchi
authors: Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors: Ken
authors: K
authors: Ohnita
authors: Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors: Tatsuki
authors: T
authors: Ichikawa
authors: Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors: Hajime
authors: H
authors: Isomoto
authors: Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors: Kazuhiko
authors: K
authors: Nakao
mesh_terms: D015331:Cohort Studies; D003093:Colitis, Ulcerative / Q000188:drug therapy* / Q000517:prevention & control*; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D060046:Maintenance Chemotherapy / Q000706:statistics & numerical data*; D019804:Mesalamine / Q000627:therapeutic use*; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D019804:Mesalamine