The insoluble excretion of multi-matrix system mesalazine preparations in patients with ulcerative colitis

BMC Gastroenterology - Tập 22 - Trang 1-7 - 2022
Yuichiro Ohtaki1, Kan Uchiyama1, Hirotaka Kamiya1, Eri Moriizumi1, Moe Yamada1, Yuma Aoki1, Toshimune Watanabe1, Sachie Kiryu1, Shizuka Suzuki1, Yoshihiro Matsumoto1, Zensho Ito1, Toshifumi Ohkusa2, Shigeo Koido1, Masayuki Saruta3
1Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University Kashiwa Hospital, Kashiwa-shi, Japan
2Department of Microbiota Research, Juntendo University Graduate School of Medicine, Bunkyo-ku, Japan
3Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Minato-ku, Japan

Tóm tắt

Multi-matrix mesalazine (MMX) is an important treatment for ulcerative colitis (UC); however, it is often excreted intact, which increases the risk of relapse. This study aimed to clarify the risk factors for insoluble MMX excretion. The subjects were 102 UC patients who were newly prescribed MMX alone to induce remission. Their stools were evaluated on the Bristol Stool Form Scale (BSFS), the presence/absence of insoluble MMX excretion was investigated in interviews, and defecation frequency at the start of treatment and disease type were retrospectively investigated by examining their medical records. The insoluble excretion rate (IER) was 14.7%. It tended to be higher in the patients with left-sided colitis or extensive colitis, although the differences among the disease types were not significant (p = 0.053). The mean defecation frequency of the patients that reported insoluble MMX excretion was significantly higher than that of the patients that did not report it (6.27 ± 5.28 vs. 3.69 ± 3.17, p < 0.05). The IER tended to be higher among the patients with soft stools (4.5%, 21.9%, and 23.1% in those with BSFS scores of ≤ 4, 5, and ≥ 6, respectively). In ROC analysis of defecation frequency, ≥ 3.5 defecations was found to exhibit sensitivity and specificity of 66.7% and 65.5%, respectively, for predicting insoluble MMX excretion. The likelihood of insoluble MMX excretion is influenced by defecation frequency and the extent of inflammation. It is important to keep the possibility of insoluble excretion in mind when prescribing MMX.

Tài liệu tham khảo

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