*Gastroenterology Unit, Herlev University Hospital, Copenhagen, Denmark;†Department of Gastroenterology, Nykoebing Falster Hospital, Nykoebing Falster, Denmark;‡Department of Gastroenterology, Nordsjaellands Hospital, Frederikssund, Denmark;§Department of Gastroenterology, Gentofte Hospital, Gentofte, Denmark;‖IBD Clinical and Research Center, ISCARE a. s., Charles University, Prague, Czech Republic;¶Department of Epidemiology Research, States Serum Institute, Copenhagen, Denmark; and**Department of Gastroenterology, St. Vincent's University Hospital, Melbourne, Australia.
Checking for direct PDF access through Ovid
Background:To individualize treatment with mesalazine for ulcerative colitis relapses through a self-managed, web-based solution to optimize the short-term disease course.Methods:Prospective, open-label, web-guided study with 3 months mesalazine therapy among patients with mild-to-moderate ulcerative colitis. Once a week, patients completed the simple clinical colitis activity index (SCCAI) and registered fecal calprotectin (FC) on the web application: www.meza.constant-care.dk. SCCAI and FC were summed and resulted in a total inflammatory burden score (TIBS). Deep remission was defined as SCCAI ≤1; FC = 0, and TIBS ≤1.Results:A total of 95 patients (62% females; median age 45 yr) were included in the study and allocated 4.8 g mesalazine per day. Of these, 82 (86%) patients were adherent to web therapy, completing 3 months of web-guided mesalazine therapy. Of the 82 adherent patients, 72 (88%) continued mesalazine and 10 (12%) needed rescue therapy. From weeks 0 to 12, patients had experienced a significant reduction in mean SCCAI (4.6 versus 1.6, P < 0.001), mean FC (437 versus 195, P < 0.001), and mean TIBS (6.7 versus 2.4, P < 0.001). Based on TIBS values (≤1), the dose of mesalazine was reduced to 2.4 g in 25% of patients at week 3 in 50% of subjects at week 5 and in 88% of patients at week 12.Conclusions:Web-guided therapy with mesalazine in mild-to-moderate ulcerative colitis helps to individualize the dose and improve adherence to therapy. The study confirms mesalazine efficacy in mild-to-moderate UC, significantly improving TIBS values in majority of the patients.