Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/53447
Citations | ||
Scopus | Web of Science® | Altmetric |
---|---|---|
?
|
?
|
Type: | Journal article |
Title: | Systematic review: does concurrent therapy with 5-ASA and immunomodulators in inflammatory bowel disease improve outcomes? |
Author: | Andrews, J. Travis, S. Gibson, P. Gasche, C. |
Citation: | Alimentary Pharmacology and Therapeutics, 2009; 29(5):459-469 |
Publisher: | Blackwell Publishing Ltd |
Issue Date: | 2009 |
ISSN: | 0269-2813 1365-2036 |
Statement of Responsibility: | J. M. Andrews, S. P. L. Travis, P. R. Gibson and C. Gasche |
Abstract: | Background: With greater use of immunomodulators in inflammatory bowel disease (IBD), it is uncertain whether concurrent therapy with both 5-aminosalicylic acid [5-ASA, mesalazine (mesalamine)] and an immunomodulator is necessary. Aim: To determine whether concurrent therapy with both 5-ASA and immunomodulator(s) improves outcomes in IBD. Methods: Systematic review with search terms 'azathioprine, 6-mercaptopurine, thiopurine(s), 5 aminosalicylic acid, mesalazine, inflammatory bowel disease, ulcerative colitis, Crohn's disease, immunosuppressant(s), immunomodulator and methotrexate' in November 2007 to identify clinical trials on concurrent 5-ASA and immunomodulator therapy. Results: Two small controlled studies were found. Neither showed a benefit on disease control beyond immunomodulator monotherapy. Potential pharmacological interactions exist between 5-ASA and thiopurines. Whilst circumstantial, epidemiological and laboratory evidence suggests that 5-ASA may assist colorectal cancer (CRC) chemoprevention, it may simply be via anti-inflammatory effects. With changes in practice, ethical issues and the long lead-time needed to demonstrate or disprove an effect, no clinical studies can/will directly answer this. The costs of avoiding one CRC in IBD may be as low as 153 times the annual cost of 5-ASA therapy. Conclusions: It is unclear whether concurrent 5-ASA and immunomodulator therapy improves outcomes of disease control, drug toxicity or compliance. Concurrent therapy of 5-ASA and immunomodulators may decrease CRC risk at 'acceptable' cost. |
Keywords: | Humans Inflammatory Bowel Diseases Aminosalicylic Acids Mesalamine Immunologic Factors Treatment Outcome Drug Therapy, Combination |
Rights: | © 2009 The Authors |
DOI: | 10.1111/j.1365-2036.2008.03915.x |
Published version: | http://dx.doi.org/10.1111/j.1365-2036.2008.03915.x |
Appears in Collections: | Aurora harvest 5 Medicine publications |
Files in This Item:
There are no files associated with this item.
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.