No benefit observed with 5ASA plus corticosteroids for acute and severe UC

January 22, 2022

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Ben-Horin S, et al. Corticosteroids and 5ASA versus corticosteroids alone for severe acute ulcerative colitis: a randomized controlled trial. Presented at: Crohn’s Disease and Colitis Congress; Jan. 20-22, 2022 (virtual meeting).

Disclosures: Ben-Horin reports financial relationships with AbbVie, BMS, Celltrion, Ferring, Galmed, Janssen, Novartis, Pfizer, Shering-Plough and Takeda.

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Corticosteroids plus 5-aminosalicylic acid were not beneficial for patients with acute and severe ulcerative colitis compared to corticosteroids alone, according to a presenter at Crohn’s and Colitis Congress.

“These results should inform our [inflammatory bowel disease] community and specialists when managing these difficult patients, to stop unnecessary 5ASA during hospitalization,” Shomron Ben Horin, MARYLAND, professor of medicine at Sheba Medical Center in Tel Aviv, Israel, said during the presentation. “On the other hand, I believe that future studies are warranted to investigate this interesting exploratory signal of better long-term outcome, at least with respect to a reduced need for biologics at day 90 in the patient receiving the combination of corticosteroids with 5ASA.”

Ben-Horin and colleagues examined 346 patients with acute and severe UC at 10 centers in six countries. They included 149 patients, who were randomly assigned to receive either corticosteroids alone (n=73) or corticosteroids plus 5ASA (n=76). The percentage of patients responding to treatment on day 7 served as the primary outcome, defined as a 3-point drop in Lichtiger score and an absolute score below 10 without the need for rescue medication or colectomy.

According to the study results, 53 patients who received corticosteroids plus 5ASA responded by day 7, compared to 58 patients who received corticosteroids alone. Ben-Horin and his colleagues found no difference between the groups in length of hospital stay or rate of normalization of C-reactive protein. Additionally, the day 90 colectomy rate was similar between treatment groups; however, the need for biologics was numerically lower at day 30 and day 90 in patients who had received corticosteroids plus 5ASA.

“The response to treatment was not different between the two groups, and there was no superiority in the administration of corticosteroids with 5ASA for the primary outcome,” Ben-Horin said. “It was also not preferable to administer corticosteroids with 5ASA for the secondary results of a need for salvage therapy.”

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