ArticleBMJ open gastroenterology2022
Modelling the benefits of an optimised treatment strategy for 5-ASA in mild-to-moderate ulcerative colitis.
Article in BMJ open gastroenterology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 25 citations in OpenAlex.
- Efficacy of Dose Escalation of Oral 5-Aminosalicylic Acid for Ulcerative Colitis With a Mayo Endoscopic Subscore of 1: An Open Label Randomized Controlled Trial.Inflammatory bowel diseases · 2025Trial
- Tailored Porous Bimetallic Nanozyme Platform for Full-Cycle Therapeutics of Intestinal Ischemia/Reperfusion.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Article
- Lyophilized mesenchymal stromal cell-derived extracellular vesicles for the oral treatment of inflammatory bowel disease: a novel cell-free therapeutic strategy.Stem cell research & therapy · 2026Article
- Redrawing the gut map: evolving probiotic approaches to microbiota modulation in inflammatory bowel disease.Antonie van Leeuwenhoek · 2026Review
- The Impact of Proactive Fecal Calprotectin Collection in an Outreach Protocol for Biologic-Naïve Ulcerative Colitis Patients-Ulcerative Colitis Clinical Outreach (UCCO).Diseases (Basel, Switzerland) · 2025Article
- From guidelines to evidence-based practice - A German perspective on mesalazine as first-line therapy for mild-to-moderate ulcerative colitis.Zeitschrift fur Gastroenterologie · 2025Review
- Anti-Inflammatory Effects of Algae-Derived Biomolecules in Gut Health: A Review.International journal of molecular sciences · 2025Review
- Evaluating the Therapeutic Efficacy ofCurrent pharmaceutical design · 2025Review
- Optimizing 5-aminosalicylate for moderate ulcerative colitis: expert recommendations from the Asia-Pacific, Middle East, and Africa Inflammatory Bowel Disease Coalition.Intestinal research · 2025Review
- Ulcerative Colitis: Advances in Pathogenesis, Biomarkers, and Therapeutic Strategies.Pharmacogenomics and personalized medicine · 2025Review
- Sustained release of 5-aminosalicylic acid from azoreductase-responsive polymeric prodrugs for prolonged colon-targeted colitis therapy.Journal of nanobiotechnology · 2024Article
- Persistence of newly prescribed 5-aminosalicylic acid in patients with ulcerative colitis: A nationwide comprehensive database study.PloS one · 2024Article
- The continuing value of mesalazine as first-line therapy for patients with moderately active ulcerative colitis.Frontiers in gastroenterology (Lausanne, Switzerland) · 2024Article
- A real-world disproportionality analysis of Tivozanib data mining of the public version of FDA adverse event reporting system.Frontiers in pharmacology · 2024Article
- A real-world disproportionality analysis of mesalazine data mining of the public version of FDA adverse event reporting system.Frontiers in pharmacology · 2024Article
- Lack of Benefit for Early Escalation to Advanced Therapies in Ulcerative Colitis: Critical Appraisal of Current Evidence.Journal of Crohn's & colitis · 2023Review
- Treatment of Patients with Mild to Moderate Ulcerative Colitis: A Middle East Expert Consensus.Journal of clinical medicine · 2023Review
- Significance of 5-Aminosalicylic Acid Intolerance in the Clinical Management of Ulcerative Colitis.Digestion · 2023Review
- Inflammatory Bowel Disease Treatments and Predictive Biomarkers of Therapeutic Response.International journal of molecular sciences · 2022Review
- Comparative Efficacy of Mesalazine and Ozanimod following Induction Treatment in Mesalazine-Exposed Advanced Therapy-Naïve Adult Ulcerative Colitis Patients.Inflammatory intestinal diseasesArticle
Corrections and comments
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Authors and funding
13 authors at 12 institutions in 12 countries.
Funding
Abstract
objectives5-aminosalicylate (mesalazine; 5-ASA) is an established first-line treatment for mild-to-moderate ulcerative colitis (UC). This study aimed to model the benefits of optimising 5-ASA therapy.
methodsA decision tree model followed 10 000 newly diagnosed patients with mild-to-moderately active UC through induction and 1 year of maintenance treatment. Optimised treatment (maximising dose of 5-ASA and use of combined oral and rectal therapy before treatment escalation) was compared with standard treatment (standard doses of 5-ASA without optimisation). Modelled data were derived from published meta-analyses. The primary outcomes were patient numbers achieving and maintaining remission, with an analysis of treatment costs for each strategy conducted as a secondary outcome (using UK reference costs).
resultsDuring induction, there was a 39% increase in patients achieving remission through the optimised pathway without requiring systemic steroids and/or biologics (6565 vs 4725 for standard). Potential steroidal/biological adverse events avoided included: seven venous thromboembolisms and eight serious infections. Out of the 6565 patients entering maintenance following successful induction on 5-ASA, there was a 21% reduction in relapses when optimised (1830 vs 2311 for standard). This translated into 297 patients avoiding further systemic steroids and 214 biologics. Optimisation led to an average net saving of £272 per patient entering the model for the induction and maintenance of remission over 1 year.
conclusionModelling suggests that optimising 5-ASA therapy (both the inclusion of rectal 5-ASA into a combined oral and rectal regimen and maximisation of 5-ASA dose) has clinical and cost benefits that supports wider adoption in clinical practice.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.