医学
结肠切除术
随机对照试验
溃疡性结肠炎
优势比
内科学
随机化
置信区间
皮质类固醇
疾病
作者
Shomron Ben‐Horin,Ofir Har-Noy,Κωνσταντίνος Κατσάνος,Xavier Roblin,Minhu Chen,Xiang Gao,Doron Schwartz,Jae Hee Cheon,Monica Cesarini,Daniela Bojic,Marijana Protić,Anǵeliki Theodoropoulou,Heba Abu-Kaf,Tal Engel,Jian Tang,Pauline Veyrard,Xiaoqing Lin,Ren Mao,Dimitrios Christodoulou,Konstantinos Karmiris,Tamara Knežević-Ivanovski
标识
DOI:10.1016/j.cgh.2022.02.055
摘要
Corticosteroids are the mainstay of treatment for hospitalized patients with acute severe ulcerative colitis (ASUC). However, whether the addition/continuation of mesalamine with corticosteroids during hospitalization is superior to corticosteroids alone is unknown.This was a randomized controlled, investigator-blinded, clinical trial conducted in 10 centers in 7 countries. Patients hospitalized with ASUC (Lichtiger score ≥10) were eligible. Patients received corticosteroids alone or corticosteroid + mesalamine (4 g/day mesalamine) by a stratified randomization according to mesalamine use before admission. The primary outcome was the percentage of patients who responded to treatment by day 7, defined by a drop >3 points in the Lichtiger score and an absolute score <10 without the need for rescue medications or colectomy.Three hundred forty-six patients were screened, and 149 were included (70/149 female; median age, 41 years). Of these, 73 received corticosteroids + mesalamine, and 76 received corticosteroids alone. For the primary outcome, 53 of 73 patients (72.6%) receiving corticosteroids with mesalamine responded versus 58 of 76 patients (76.3%) on corticosteroids alone (odds ratio, 0.82; 95% confidence interval, 0.39-1.72; P = .60). There was no difference between groups in duration of hospitalization, C-reactive protein normalization rate, or colectomy rate up to day 90. The need for biologics among patients receiving combination of corticosteroids with mesalamine was numerically lower by day 30 (P = .11) and day 90 (P = .07).In this randomized controlled trial, combination of mesalamine with corticosteroids did not benefit hospitalized patients with ASUC more than corticosteroids alone. An exploratory signal for a reduced need for biologics at 90 days in the mesalamine group merits further evaluation.gov ID: NCT01941589.
科研通智能强力驱动
Strongly Powered by AbleSci AI