Year 2021 / Volume 113 / Number 6
Review
Risk factors and management strategies associated with non-response to aminosalicylates as a maintenance treatment in ulcerative colitis

447-453

DOI: 10.17235/reed.2021.7797/2021

David Martí-Aguado, María Pilar Ballester, Miguel Mínguez,

Abstract
Aminosalicylates (5-ASA) are used as the first-line maintenance treatment in patients with mild-moderate ulcerative colitis (UC). Early identification of patients at high risk for 5-ASA non-response and appropriate therapeutic escalation are essential to avoid disease progression. However, the absence of a standardized definition for treatment success makes this a challenging task. The focus of the current review was to describe the risk factors and management strategies associated with 5-ASA non-response. Rates of 5-ASA failure can vary from 17 % to 75 % according to different success definitions, of which clinical relapse is the most prevalent and studied condition. Younger age and endoscopic activity at diagnosis, extensive colitis, early need for corticosteroids, elevated inflammatory markers and non-adherence are consistent risk factors of 5-ASA failure. Given the effectiveness, safety profile and tolerability of this medication, therapy optimization is critical before treatment escalation. Combined use of systemic and topical therapy at an appropriate dose in a once-daily administration and control of adherence could improve success rates.
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Martí-Aguado D, Ballester M, Mínguez M. Risk factors and management strategies associated with non-response to aminosalicylates as a maintenance treatment in ulcerative colitis. 7797/2021


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Publication history

Received: 15/01/2021

Accepted: 21/01/2021

Online First: 11/02/2021

Published: 04/06/2021

Article revision time: 2 days

Article Online First time: 27 days

Article editing time: 140 days


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