PDF(Pubmed)
Abstract：
UNASSIGNED: 5-aminosalicylates (5-ASA) are used to treat mild to moderate ulcerative colitis. Despite their lack of efficacy in Crohn disease (CD), they are still used in real-world practice. Additionally, when patients have progressive disease, they may escalate to biologic therapy, at which time 5-ASA may or may not be discontinued.
UNASSIGNED: The aim of this study is to assess the clinical outcomes of patients started on 5-ASA for the treatment of pediatric CD. The secondary aims were to evaluate the outcomes of those who continue 5-ASA to those who discontinue 5-ASA upon biologic escalation.
UNASSIGNED: We performed a single-center retrospective chart review of pediatric CD patients from 2010 to 2019 who were initially treated with 5-ASA. Demographics, medication and laboratory data, and clinical disease activity were collected.
UNASSIGNED: Sixty-one patients were included in the study; the majority had inflammatory CD with ileocolonic involvement. Twenty-four patients were on a concomitant immunomodulator. The majority of patients (85.2%) required escalation to biologics. Thirty-two patients (61.5%) who escalated to biologic therapy continued on 5-ASA. Eighty percent of patients achieved clinical remission at 1 year, and there was no difference between those who continued 5-ASA at time of biologic initiation compared to those who did not continue the medication. Patients who discontinued 5-ASA had an average annual cost savings of $6741.
UNASSIGNED: 5-ASA is not a durable monotherapy for the treatment of pediatric CD. Patients who require escalation from 5-ASA to biologic therapy do not benefit from concomitant 5-ASA therapy. Further prospective studies are needed to confirm these findings.
UNASSIGNED: The aim of this study is to assess the clinical outcomes of patients started on 5-ASA for the treatment of pediatric CD. The secondary aims were to evaluate the outcomes of those who continue 5-ASA to those who discontinue 5-ASA upon biologic escalation.
UNASSIGNED: We performed a single-center retrospective chart review of pediatric CD patients from 2010 to 2019 who were initially treated with 5-ASA. Demographics, medication and laboratory data, and clinical disease activity were collected.
UNASSIGNED: Sixty-one patients were included in the study; the majority had inflammatory CD with ileocolonic involvement. Twenty-four patients were on a concomitant immunomodulator. The majority of patients (85.2%) required escalation to biologics. Thirty-two patients (61.5%) who escalated to biologic therapy continued on 5-ASA. Eighty percent of patients achieved clinical remission at 1 year, and there was no difference between those who continued 5-ASA at time of biologic initiation compared to those who did not continue the medication. Patients who discontinued 5-ASA had an average annual cost savings of $6741.
UNASSIGNED: 5-ASA is not a durable monotherapy for the treatment of pediatric CD. Patients who require escalation from 5-ASA to biologic therapy do not benefit from concomitant 5-ASA therapy. Further prospective studies are needed to confirm these findings.
摘要：
5-氨基水杨酸盐(5-ASA)用于治疗轻度至中度溃疡性结肠炎。尽管他们在克罗恩病（CD）中缺乏疗效，它们仍然用于现实世界的实践。此外,当患者患有进行性疾病时，他们可能会升级到生物治疗，此时5-ASA可以停用,也可以不停用.
■本研究的目的是评估开始使用5-ASA治疗小儿CD的患者的临床结果。次要目的是评估那些继续5-ASA的人与那些在生物学升级后停止5-ASA的人的结果。
■我们对2010年至2019年最初接受5-ASA治疗的小儿CD患者进行了单中心回顾性图表审查。人口统计,药物和实验室数据，并收集临床疾病活动。
■61例患者被纳入研究；大多数患者有回肠结肠受累的炎性CD。24名患者同时使用免疫调节剂。大多数患者（85.2％）需要升级生物制剂。32例（61.5％）逐步升级为生物治疗的患者继续接受5-ASA。80%的患者在1年内达到临床缓解，在生物开始时继续使用5-ASA的患者与未继续药物治疗的患者之间没有差异.停用5-ASA的患者平均每年可节省6741美元的费用。
■5-ASA不是治疗小儿CD的持久单一疗法。需要从5-ASA升级到生物治疗的患者不能从伴随的5-ASA治疗中获益。需要进一步的前瞻性研究来证实这些发现。
■本研究的目的是评估开始使用5-ASA治疗小儿CD的患者的临床结果。次要目的是评估那些继续5-ASA的人与那些在生物学升级后停止5-ASA的人的结果。
■我们对2010年至2019年最初接受5-ASA治疗的小儿CD患者进行了单中心回顾性图表审查。人口统计,药物和实验室数据，并收集临床疾病活动。
■61例患者被纳入研究；大多数患者有回肠结肠受累的炎性CD。24名患者同时使用免疫调节剂。大多数患者（85.2％）需要升级生物制剂。32例（61.5％）逐步升级为生物治疗的患者继续接受5-ASA。80%的患者在1年内达到临床缓解，在生物开始时继续使用5-ASA的患者与未继续药物治疗的患者之间没有差异.停用5-ASA的患者平均每年可节省6741美元的费用。
■5-ASA不是治疗小儿CD的持久单一疗法。需要从5-ASA升级到生物治疗的患者不能从伴随的5-ASA治疗中获益。需要进一步的前瞻性研究来证实这些发现。
