title: What is the real-life maintenance mesalazine dose in ulcerative colitis?
abstract: OBJECTIVE
  To describe how mesalazine (MSZ) is used in our practice in ulcerative colitis (UC), at what dose, and the success rate (regarding adherence to therapy).
  
  
  METHODS
  Observational, transversal study, including all patients with UC and with MSZ maintenance therapy seen from September 2014 to February 2015 at two IBD units in Spain. Treatment adherence was measured by the Morisky-Green scale.
  
  
  RESULTS
  We included 203 patients (mean MSZ dose: 2.6 ± 1.0 g/d; median of treatment: 19.5 months [IQR: 8-48]). Doses < 2 g/d were used in 15.3% of cases, 2-2.9 g/d doses in 35.0%, 3-3.9 doses in 29.5%, and ≥ 4 g/d doses in the remaining 20.2%. A single daily dose was preferred in 51.2% of cases, two doses in 33.0% and three doses in 15.8%. A different MSZ brand had been previously used in 36.6% of patients. In 134 cases (66%), the maintenance dose had been increased during a flare-up, and in 49 (36.6% of cases) this higher dose had been kept for maintenance (dose ≥ 4 g/d in 36 patients). During the MSZ therapy, 14 patients (6.9%) suffered mild side effects (21.4% altered liver function tests). Therapy adherence was good in 81.8% of cases.
  
  
  CONCLUSIONS
  Half of our UC patients take high MSZ doses (≥ 3 g/d) as maintenance therapy, with acceptable safety and good adherence. Half of all patients take a single daily dose, and one third needed a different commercial brand during therapy. Opting for a higher MSZ maintenance dose is a possible strategy for a satisfactory maintenance therapy.
authors.affiliation: Digestivo, Hospital Universitario de Fuenlabrada, España.
authors.forename: Alicia
authors.initials: A
authors.lastname: Algaba
authors.affiliation: Digestivo, Hospital Universitario de Fuenlabrada.
authors.forename: Iván
authors.initials: I
authors.lastname: Guerra
authors.affiliation: Servicio de Gastroenterología, Hospital Universitario Ramón y Cajal, España.
authors.forename: Ana
authors.initials: A
authors.lastname: García García de Paredes
authors.affiliation: Digestivo, Hospital Universitario de Fuenlabrada.
authors.forename: María
authors.initials: M
authors.lastname: Hernández Tejero
authors.affiliation: Servicio de Gastroenterología, Hospital Universitario Ramón y Cajal.
authors.forename: Carlos
authors.initials: C
authors.lastname: Ferre
authors.affiliation: Digestivo, Hospital Universitario de Fuenlabrada.
authors.forename: Daniel
authors.initials: D
authors.lastname: Bonillo
authors.affiliation: Servicio de Gastroenterología, Hospital Universitario Ramón y Cajal.
authors.forename: Lara
authors.initials: L
authors.lastname: Aguilera
authors.affiliation: Servicio de Gastroenterología, Hospital Universitario Ramón y Cajal, ESPAÑA.
authors.forename: Antonio
authors.initials: A
authors.lastname: López-Sanromán
authors.affiliation: Digestivo, Hospital Universitario de Fuenlabrada.
authors.forename: Fernando
authors.initials: F
authors.lastname: Bermejo
mesh_terms: D000328:Adult; D000368:Aged; D000897:Anti-Ulcer Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D054539:Medication Therapy Management; D019804:Mesalamine / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged
chemical_list: D000897:Anti-Ulcer Agents; D019804:Mesalamine