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Intermittent versus every-day mesalazine therapy in preventing complications of diverticular disease: a long-term follow-up study.

AbstractBACKGROUND:
Mesalazine seems to be effective in preventing recurrence of acute uncomplicated diverticulitis (AUD), but the optimal mesalazine scheme to achieve these results is still debated.
AIM:
To assess the effectiveness of two different mesalazine-based treatments in preventing recurrence of AUD and the occurrence of other complications of diverticular disease (DD) during a long-term follow-up.
PATIENTS AND METHODS:
We reviewed 311 patients suffer from recent episode of AUD and undergoing to mesalazine treatment: 207 (group A, 105 males, median age 63 years, range 47-74 years) were treated with mesalazine 1.6 g for 10 days each month, whilst 104 (group B, 55 males, median age 65 years, range 50-72 years) were treated with mesalazine 1.6 g every day. Patients were followed-up every 6 months (median 7.5 months, range 5-13 months).
RESULTS:
Patients were followed-up for a mean time of 3 years (range 12-72 months). Overall, occurrence of complication recurred more frequently in group A than in group B (p = 0.030, log-rank test). Acute diverticulitis recurred in 17 (8.2%) patients in group A and in 3 (2.9%) in group B; diverticular bleeding occurred in 4 (1.9%) patients in group A and in 1 (0.96%) patient in group B; surgery was required in 3 (1.4%) patients in group A and in no (0%) patient in group B.
CONCLUSIONS:
This is the first study showing that long-term mesalazine treatment is significantly better that intermittent mesalazine treatment in preventing occurrence of DD complications after an attack of acute diverticulitis.
AuthorsA Tursi, F Di Mario, G Brandimarte, W Elisei, M Picchio, S Loperfido, N Dal Bo', F Ferrara, R Marcello, H Heras Salvat, C Scarpignato
JournalEuropean review for medical and pharmacological sciences (Eur Rev Med Pharmacol Sci) Vol. 17 Issue 23 Pg. 3244-8 (Dec 2013) ISSN: 1128-3602 [Print] Italy
PMID24338468 (Publication Type: Comparative Study, Journal Article)
Chemical References
  • Anti-Inflammatory Agents, Non-Steroidal
  • Gastrointestinal Agents
  • Mesalamine
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Inflammatory Agents, Non-Steroidal (administration & dosage, adverse effects)
  • Chi-Square Distribution
  • Diverticulitis, Colonic (diagnosis, etiology, prevention & control)
  • Diverticulosis, Colonic (complications, diagnosis, drug therapy)
  • Diverticulum, Colon (complications, diagnosis, drug therapy)
  • Drug Administration Schedule
  • Female
  • Follow-Up Studies
  • Gastrointestinal Agents (administration & dosage, adverse effects)
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Mesalamine (administration & dosage, adverse effects)
  • Middle Aged
  • Retrospective Studies
  • Secondary Prevention
  • Time Factors
  • Treatment Outcome

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