Comparison of Concomitant Mesalamine and Immunomodulator Therapy and Immunomodulator Monotherapy for Crohn's Disease

Min Seob Kwak, Kyung Jo Kim, Jae Hee Cheon, Wan Soo Kim, Jeong Mi Lee, Sung Wook Hwang, Sang Hyoung Park, Dong Hoon Yang, Byong Duk Ye, Jeong Sik Byeon, Seung Jae Myung, Suk Kyun Yang

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background. Although immunomodulators are increasingly used in Crohn's disease (CD), a significant number of gastroenterologists still use 5-aminosalicylate (5-ASA) in combination with azathioprine (AZA) or 6-mercaptopurine (6-MP); there is limited evidence regarding the benefit of concomitant 5-ASA with AZA/6-MP compared with AZA/6-MP monotherapy for the treatment of CD. Study Design. A total of 106 patients who received AZA/6-MP for more than 3 months between January 1991 and May 2014 were identified retrospectively. Each patient was matched with 3 randomly selected controls who were treated with concomitant therapy during the same period. Results. The cumulative probabilities of steroid use at 5 and 10 years were 24.9% and 75.8% in the 5-ASA + AZA/6-MP group and 31.2% and 87.8% in the AZA/6-MP group, respectively (P=0.187). The cumulative probabilities of anti-TNF use, resectional surgery, and disease-related hospitalization were comparable between the groups. The younger age and the use of lower doses of immunomodulators were associated with higher requirement of rescue therapy. Conclusions. This study did not demonstrate that the concomitant use of 5-ASA with AZA/6-MP showed the proof or effect in terms of steroid requirements, anti-TNF use, resectional surgery, or disease-related hospitalization compared with that of AZA/6-MP alone.

Original languageEnglish
Article number4826973
JournalGastroenterology Research and Practice
Volume2018
DOIs
Publication statusPublished - 2018 Jan 1

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Mesalamine
6-Mercaptopurine
Azathioprine
Immunologic Factors
Crohn Disease
Therapeutics
Hospitalization
Steroids

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

Kwak, Min Seob ; Kim, Kyung Jo ; Cheon, Jae Hee ; Kim, Wan Soo ; Lee, Jeong Mi ; Hwang, Sung Wook ; Park, Sang Hyoung ; Yang, Dong Hoon ; Ye, Byong Duk ; Byeon, Jeong Sik ; Myung, Seung Jae ; Yang, Suk Kyun. / Comparison of Concomitant Mesalamine and Immunomodulator Therapy and Immunomodulator Monotherapy for Crohn's Disease. In: Gastroenterology Research and Practice. 2018 ; Vol. 2018.
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title = "Comparison of Concomitant Mesalamine and Immunomodulator Therapy and Immunomodulator Monotherapy for Crohn's Disease",
abstract = "Background. Although immunomodulators are increasingly used in Crohn's disease (CD), a significant number of gastroenterologists still use 5-aminosalicylate (5-ASA) in combination with azathioprine (AZA) or 6-mercaptopurine (6-MP); there is limited evidence regarding the benefit of concomitant 5-ASA with AZA/6-MP compared with AZA/6-MP monotherapy for the treatment of CD. Study Design. A total of 106 patients who received AZA/6-MP for more than 3 months between January 1991 and May 2014 were identified retrospectively. Each patient was matched with 3 randomly selected controls who were treated with concomitant therapy during the same period. Results. The cumulative probabilities of steroid use at 5 and 10 years were 24.9{\%} and 75.8{\%} in the 5-ASA + AZA/6-MP group and 31.2{\%} and 87.8{\%} in the AZA/6-MP group, respectively (P=0.187). The cumulative probabilities of anti-TNF use, resectional surgery, and disease-related hospitalization were comparable between the groups. The younger age and the use of lower doses of immunomodulators were associated with higher requirement of rescue therapy. Conclusions. This study did not demonstrate that the concomitant use of 5-ASA with AZA/6-MP showed the proof or effect in terms of steroid requirements, anti-TNF use, resectional surgery, or disease-related hospitalization compared with that of AZA/6-MP alone.",
author = "Kwak, {Min Seob} and Kim, {Kyung Jo} and Cheon, {Jae Hee} and Kim, {Wan Soo} and Lee, {Jeong Mi} and Hwang, {Sung Wook} and Park, {Sang Hyoung} and Yang, {Dong Hoon} and Ye, {Byong Duk} and Byeon, {Jeong Sik} and Myung, {Seung Jae} and Yang, {Suk Kyun}",
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Kwak, MS, Kim, KJ, Cheon, JH, Kim, WS, Lee, JM, Hwang, SW, Park, SH, Yang, DH, Ye, BD, Byeon, JS, Myung, SJ & Yang, SK 2018, 'Comparison of Concomitant Mesalamine and Immunomodulator Therapy and Immunomodulator Monotherapy for Crohn's Disease', Gastroenterology Research and Practice, vol. 2018, 4826973. https://doi.org/10.1155/2018/4826973

Comparison of Concomitant Mesalamine and Immunomodulator Therapy and Immunomodulator Monotherapy for Crohn's Disease. / Kwak, Min Seob; Kim, Kyung Jo; Cheon, Jae Hee; Kim, Wan Soo; Lee, Jeong Mi; Hwang, Sung Wook; Park, Sang Hyoung; Yang, Dong Hoon; Ye, Byong Duk; Byeon, Jeong Sik; Myung, Seung Jae; Yang, Suk Kyun.

In: Gastroenterology Research and Practice, Vol. 2018, 4826973, 01.01.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Comparison of Concomitant Mesalamine and Immunomodulator Therapy and Immunomodulator Monotherapy for Crohn's Disease

AU - Kwak, Min Seob

AU - Kim, Kyung Jo

AU - Cheon, Jae Hee

AU - Kim, Wan Soo

AU - Lee, Jeong Mi

AU - Hwang, Sung Wook

AU - Park, Sang Hyoung

AU - Yang, Dong Hoon

AU - Ye, Byong Duk

AU - Byeon, Jeong Sik

AU - Myung, Seung Jae

AU - Yang, Suk Kyun

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background. Although immunomodulators are increasingly used in Crohn's disease (CD), a significant number of gastroenterologists still use 5-aminosalicylate (5-ASA) in combination with azathioprine (AZA) or 6-mercaptopurine (6-MP); there is limited evidence regarding the benefit of concomitant 5-ASA with AZA/6-MP compared with AZA/6-MP monotherapy for the treatment of CD. Study Design. A total of 106 patients who received AZA/6-MP for more than 3 months between January 1991 and May 2014 were identified retrospectively. Each patient was matched with 3 randomly selected controls who were treated with concomitant therapy during the same period. Results. The cumulative probabilities of steroid use at 5 and 10 years were 24.9% and 75.8% in the 5-ASA + AZA/6-MP group and 31.2% and 87.8% in the AZA/6-MP group, respectively (P=0.187). The cumulative probabilities of anti-TNF use, resectional surgery, and disease-related hospitalization were comparable between the groups. The younger age and the use of lower doses of immunomodulators were associated with higher requirement of rescue therapy. Conclusions. This study did not demonstrate that the concomitant use of 5-ASA with AZA/6-MP showed the proof or effect in terms of steroid requirements, anti-TNF use, resectional surgery, or disease-related hospitalization compared with that of AZA/6-MP alone.

AB - Background. Although immunomodulators are increasingly used in Crohn's disease (CD), a significant number of gastroenterologists still use 5-aminosalicylate (5-ASA) in combination with azathioprine (AZA) or 6-mercaptopurine (6-MP); there is limited evidence regarding the benefit of concomitant 5-ASA with AZA/6-MP compared with AZA/6-MP monotherapy for the treatment of CD. Study Design. A total of 106 patients who received AZA/6-MP for more than 3 months between January 1991 and May 2014 were identified retrospectively. Each patient was matched with 3 randomly selected controls who were treated with concomitant therapy during the same period. Results. The cumulative probabilities of steroid use at 5 and 10 years were 24.9% and 75.8% in the 5-ASA + AZA/6-MP group and 31.2% and 87.8% in the AZA/6-MP group, respectively (P=0.187). The cumulative probabilities of anti-TNF use, resectional surgery, and disease-related hospitalization were comparable between the groups. The younger age and the use of lower doses of immunomodulators were associated with higher requirement of rescue therapy. Conclusions. This study did not demonstrate that the concomitant use of 5-ASA with AZA/6-MP showed the proof or effect in terms of steroid requirements, anti-TNF use, resectional surgery, or disease-related hospitalization compared with that of AZA/6-MP alone.

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DO - 10.1155/2018/4826973

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