Predictive factors of relapse after dose reduction of oral 5-aminosalicylic acid in patients with ulcerative colitis in the remission phase.
<h4>Objectives</h4>Useful indices to determine whether to reduce the dose of 5-aminosalicylic acid (5-ASA) in patients with ulcerative colitis (UC) during remission remain unclear. We aimed to analyze the rate and risk factors of relapse after reducing the dose of oral 5-ASA used for mai...
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2021
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oai:doaj.org-article:4de879a84bbe452e9d62940bd4d5bb4c2021-12-02T20:18:43ZPredictive factors of relapse after dose reduction of oral 5-aminosalicylic acid in patients with ulcerative colitis in the remission phase.1932-620310.1371/journal.pone.0255620https://doaj.org/article/4de879a84bbe452e9d62940bd4d5bb4c2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0255620https://doaj.org/toc/1932-6203<h4>Objectives</h4>Useful indices to determine whether to reduce the dose of 5-aminosalicylic acid (5-ASA) in patients with ulcerative colitis (UC) during remission remain unclear. We aimed to analyze the rate and risk factors of relapse after reducing the dose of oral 5-ASA used for maintenance therapy of UC.<h4>Methods</h4>UC patients whose 5-ASA dose was reduced in clinical remission (partial Mayo score of ≤ 1) at our institution from 2012 to 2017 were analyzed. Various clinical variables of patients who relapsed after reducing the dose of oral 5-ASA were compared with those of patients who maintained remission. Risk factors for relapse were assessed by univariate and multivariate logistic regression analyses. Cumulative relapse-free survival rates were calculated using the Kaplan-Meier method.<h4>Results</h4>A total of 70 UC patients were included; 52 (74.3%) patients maintained remission and 18 (25.7%) patients relapsed during the follow-up period. Multivariate analysis indicated that a history of acute severe UC (ASUC) was an independent predictive factor for clinical relapse (p = 0.024, odds ratio: 21, 95% confidence interval: 1.50-293.2). Based on Kaplan-Meier survival analysis, the cumulative relapse-free survival rate within 52 weeks was 22.2% for patients with a history of ASUC, compared with 82.0% for those without. the log-rank test showed a significant difference in a history of ASUC (p < 0.001).<h4>Conclusions</h4>Dose reduction of 5-ASA should be performed carefully in patients who have a history of ASUC.Akira MadarameMasakatsu FukuzawaYoshiya YamauchiShin KonoAkihiko SugimotoHayato YamaguchiTakashi MoriseYohei KoyamaKumiko UchidaMaya SuguroTaisuke MatsumotoKagawa YasuyukiTakashi KawaiTakao ItoiPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 8, p e0255620 (2021) |
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Medicine R Science Q Akira Madarame Masakatsu Fukuzawa Yoshiya Yamauchi Shin Kono Akihiko Sugimoto Hayato Yamaguchi Takashi Morise Yohei Koyama Kumiko Uchida Maya Suguro Taisuke Matsumoto Kagawa Yasuyuki Takashi Kawai Takao Itoi Predictive factors of relapse after dose reduction of oral 5-aminosalicylic acid in patients with ulcerative colitis in the remission phase. |
| description |
<h4>Objectives</h4>Useful indices to determine whether to reduce the dose of 5-aminosalicylic acid (5-ASA) in patients with ulcerative colitis (UC) during remission remain unclear. We aimed to analyze the rate and risk factors of relapse after reducing the dose of oral 5-ASA used for maintenance therapy of UC.<h4>Methods</h4>UC patients whose 5-ASA dose was reduced in clinical remission (partial Mayo score of ≤ 1) at our institution from 2012 to 2017 were analyzed. Various clinical variables of patients who relapsed after reducing the dose of oral 5-ASA were compared with those of patients who maintained remission. Risk factors for relapse were assessed by univariate and multivariate logistic regression analyses. Cumulative relapse-free survival rates were calculated using the Kaplan-Meier method.<h4>Results</h4>A total of 70 UC patients were included; 52 (74.3%) patients maintained remission and 18 (25.7%) patients relapsed during the follow-up period. Multivariate analysis indicated that a history of acute severe UC (ASUC) was an independent predictive factor for clinical relapse (p = 0.024, odds ratio: 21, 95% confidence interval: 1.50-293.2). Based on Kaplan-Meier survival analysis, the cumulative relapse-free survival rate within 52 weeks was 22.2% for patients with a history of ASUC, compared with 82.0% for those without. the log-rank test showed a significant difference in a history of ASUC (p < 0.001).<h4>Conclusions</h4>Dose reduction of 5-ASA should be performed carefully in patients who have a history of ASUC. |
| format |
article |
| author |
Akira Madarame Masakatsu Fukuzawa Yoshiya Yamauchi Shin Kono Akihiko Sugimoto Hayato Yamaguchi Takashi Morise Yohei Koyama Kumiko Uchida Maya Suguro Taisuke Matsumoto Kagawa Yasuyuki Takashi Kawai Takao Itoi |
| author_facet |
Akira Madarame Masakatsu Fukuzawa Yoshiya Yamauchi Shin Kono Akihiko Sugimoto Hayato Yamaguchi Takashi Morise Yohei Koyama Kumiko Uchida Maya Suguro Taisuke Matsumoto Kagawa Yasuyuki Takashi Kawai Takao Itoi |
| author_sort |
Akira Madarame |
| title |
Predictive factors of relapse after dose reduction of oral 5-aminosalicylic acid in patients with ulcerative colitis in the remission phase. |
| title_short |
Predictive factors of relapse after dose reduction of oral 5-aminosalicylic acid in patients with ulcerative colitis in the remission phase. |
| title_full |
Predictive factors of relapse after dose reduction of oral 5-aminosalicylic acid in patients with ulcerative colitis in the remission phase. |
| title_fullStr |
Predictive factors of relapse after dose reduction of oral 5-aminosalicylic acid in patients with ulcerative colitis in the remission phase. |
| title_full_unstemmed |
Predictive factors of relapse after dose reduction of oral 5-aminosalicylic acid in patients with ulcerative colitis in the remission phase. |
| title_sort |
predictive factors of relapse after dose reduction of oral 5-aminosalicylic acid in patients with ulcerative colitis in the remission phase. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2021 |
| url |
https://doaj.org/article/4de879a84bbe452e9d62940bd4d5bb4c |
| work_keys_str_mv |
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| _version_ |
1718374222189821952 |