title: eHealth: individualization of mesalazine treatment through a self-managed web-based solution in mild-to-moderate ulcerative colitis.
abstract: BACKGROUND
  To individualize treatment with mesalazine for ulcerative colitis relapses through a self-managed, web-based solution to optimize the short-term disease course.
  
  
  METHODS
  Prospective, open-label, web-guided study with 3 months mesalazine therapy among patients with mild-to-moderate ulcerative colitis. Once a week, patients completed the simple clinical colitis activity index (SCCAI) and registered fecal calprotectin (FC) on the web application: www.meza.constant-care.dk. SCCAI and FC were summed and resulted in a total inflammatory burden score (TIBS). Deep remission was defined as SCCAI ≤1; FC = 0, and TIBS ≤1.
  
  
  RESULTS
  A total of 95 patients (62% females; median age 45 yr) were included in the study and allocated 4.8 g mesalazine per day. Of these, 82 (86%) patients were adherent to web therapy, completing 3 months of web-guided mesalazine therapy. Of the 82 adherent patients, 72 (88%) continued mesalazine and 10 (12%) needed rescue therapy. From weeks 0 to 12, patients had experienced a significant reduction in mean SCCAI (4.6 versus 1.6, P < 0.001), mean FC (437 versus 195, P < 0.001), and mean TIBS (6.7 versus 2.4, P < 0.001). Based on TIBS values (≤1), the dose of mesalazine was reduced to 2.4 g in 25% of patients at week 3 in 50% of subjects at week 5 and in 88% of patients at week 12.
  
  
  CONCLUSIONS
  Web-guided therapy with mesalazine in mild-to-moderate ulcerative colitis helps to individualize the dose and improve adherence to therapy. The study confirms mesalazine efficacy in mild-to-moderate UC, significantly improving TIBS values in majority of the patients.
authors.affiliation: *Gastroenterology Unit, Herlev University Hospital, Copenhagen, Denmark; †Department of Gastroenterology, Nykoebing Falster Hospital, Nykoebing Falster, Denmark; ‡Department of Gastroenterology, Nordsjaellands Hospital, Frederikssund, Denmark; §Department of Gastroenterology, Gentofte Hospital, Gentofte, Denmark; ‖IBD Clinical and Research Center, ISCARE a. s., Charles University, Prague, Czech Republic; ¶Department of Epidemiology Research, States Serum Institute, Copenhagen, Denmark; and **Department of Gastroenterology, St. Vincent's University Hospital, Melbourne, Australia.
authors.forename: Natalia
authors.initials: N
authors.lastname: Pedersen
authors.forename: Peter
authors.initials: P
authors.lastname: Thielsen
authors.forename: Lars
authors.initials: L
authors.lastname: Martinsen
authors.forename: Mette
authors.initials: M
authors.lastname: Bennedsen
authors.forename: Anne
authors.initials: A
authors.lastname: Haaber
authors.forename: Ebbe
authors.initials: E
authors.lastname: Langholz
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Végh
authors.forename: Dana
authors.initials: D
authors.lastname: Duricova
authors.forename: Tine
authors.initials: T
authors.lastname: Jess
authors.forename: Sally
authors.initials: S
authors.lastname: Bell
authors.forename: Johan
authors.initials: J
authors.lastname: Burisch
authors.forename: Pia
authors.initials: P
authors.lastname: Munkholm
mesh_terms: D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D003093:Colitis, Ulcerative / Q000188:drug therapy* / Q000523:psychology; D003194:Computer-Assisted Instruction; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet; D008297:Male; D055118:Medication Adherence; D019804:Mesalamine / Q000627:therapeutic use*; D008875:Middle Aged; D010353:Patient Education as Topic; D057285:Precision Medicine; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D012008:Recurrence; D012648:Self Care; D012720:Severity of Illness Index; D017216:Telemedicine; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D019804:Mesalamine