title: Timing for dose-down of 5-ASA depends on mucosal status with ulcerative colitis.
abstract: OBJECTIVE
  Although aminosalicylic acid (ASA) preparations have been used as first-line drugs for the treatment of ulcerative colitis (UC), no consistent view has been established regarding the ASA dose during the remission-maintenance phase of the disease. In this study, we examined whether the ASA dose should be reduced during the remission-maintenance phase.
  
  
  METHODS
  This study included 203 patients in the remission-maintenance phase of UC. The Mayo endoscopic subscore (MES) was used to evaluate mucosa. Comparison and analysis were performed between patients whose ASA dose had been unchanged and whose dose had been reduced, between patients with endoscopic healing (EH) group and those without endoscopic healing (WEH) group, and between patients with an MES of 0 and 1.
  
  
  RESULTS
  Comparison between the unchanged-ASA and reduced-ASA groups revealed that the remission-maintenance rate was higher in the unchanged-ASA group (p < 0.001). Next, the remission-maintenance rate was higher in the EH/unchanged-ASA group than in the EH/reduced-ASA group (p = 0.042). Comparison between the MES 0 and 1 groups revealed that the remission-maintenance rate was higher in the MES 0 group (p = 0.007). In addition, no significant difference in remission-maintenance rates was observed between the MES 0/unchanged-ASA group and the MES 0/reduced-ASA group (p = 0.108).
  
  
  CONCLUSIONS
  When the same ASA dose is maintained regardless of the presence or absence of EH, remission is more likely to be maintained. If the ASA dose must be reduced, dose reduction is more advantageous after an MES of 0 is achieved.
authors: a Department of Gastroenterology , Dokkyo Medical University , Tochigi , Japan ;
authors: Fumiaki
authors: F
authors: Takahashi
authors: a Department of Gastroenterology , Dokkyo Medical University , Tochigi , Japan ;
authors: Keiichi
authors: K
authors: Tominaga
authors: a Department of Gastroenterology , Dokkyo Medical University , Tochigi , Japan ;
authors: Akira
authors: A
authors: Kanamori
authors: a Department of Gastroenterology , Dokkyo Medical University , Tochigi , Japan ;
authors: Kazuhiro
authors: K
authors: Takenaka
authors: b Department of Internal Medicine , Japanese Red Cross Ashikaga Hospital , Tochigi , Japan.
authors: Atsushi
authors: A
authors: Hoshino
authors: a Department of Gastroenterology , Dokkyo Medical University , Tochigi , Japan ;
authors: Takeshi
authors: T
authors: Sugaya
authors: a Department of Gastroenterology , Dokkyo Medical University , Tochigi , Japan ;
authors: Masakazu
authors: M
authors: Nakano
authors: a Department of Gastroenterology , Dokkyo Medical University , Tochigi , Japan ;
authors: Hideyuki
authors: H
authors: Hiraishi
mesh_terms: D010131:Aminosalicylic Acid / Q000008:administration & dosage*; D003093:Colitis, Ulcerative / Q000188:drug therapy* / Q000473:pathology; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012074:Remission Induction
chemical_list: D010131:Aminosalicylic Acid
keywords: Aminosalicylic acid; clinical remission; endoscopic healing; ulcerative colitis