title: The gap between scientific evidence and clinical practice: 5-aminosalicylates are frequently used for the treatment of Crohn's disease.
abstract: BACKGROUND
  There is uncertain evidence of effectiveness of 5-aminosalicylates (5-ASA) to induce and maintain response and remission of active Crohn's disease (CD), and weak evidence to support their use in post-operative CD.
  
  
  OBJECTIVE
  To assess the frequency and determinants of 5-ASA use in CD patients and to evaluate the physicians' perception of clinical response and side effects to 5-ASA.
  
  
  METHODS
  Data from the Swiss Inflammatory Bowel Disease Cohort, which collects data since 2006 on a large sample of IBD patients, were analysed. Information from questionnaires regarding utilisation of treatments and perception of response to 5-ASA were evaluated. Logistic regression modelling was performed to identify factors associated with 5-ASA use.
  
  
  RESULTS
  Of 1420 CD patients, 835 (59%) were ever treated with 5-ASA from diagnosis to latest follow-up. Disease duration >10 years and colonic location were both significantly associated with 5-ASA use. 5-ASA treatment was judged to be successful in 46% (378/825) of treatment episodes (physician global assessment). Side effects prompting stop of therapy were found in 12% (98/825) episodes in which 5-ASA had been stopped.
  
  
  CONCLUSIONS
  5-Aminosalicylates were frequently prescribed in patients with Crohn's disease in the Swiss IBD cohort. This observation stands in contrast to the scientific evidence demonstrating a very limited role of 5-ASA compounds in the treatment of Crohn's disease.
authors.affiliation: Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
authors.forename: A M
authors.initials: AM
authors.lastname: Schoepfer
authors.forename: M
authors.initials: M
authors.lastname: Bortolotti
authors.forename: V
authors.initials: V
authors.lastname: Pittet
authors.forename: C
authors.initials: C
authors.lastname: Mottet
authors.forename: J-J
authors.initials: JJ
authors.lastname: Gonvers
authors.forename: O
authors.initials: O
authors.lastname: Reich
authors.forename: N
authors.initials: N
authors.lastname: Fournier
authors.forename: J-P
authors.initials: JP
authors.lastname: Vader
authors.forename: B
authors.initials: B
authors.lastname: Burnand
authors.forename: P
authors.initials: P
authors.lastname: Michetti
authors.forename: F
authors.initials: F
authors.lastname: Froehlich
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003424:Crohn Disease / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D019804:Mesalamine / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D011795:Surveys and Questionnaires; D013557:Switzerland / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D019804:Mesalamine