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Castillo-Regalado E, Ríos R, Aràjol C, Gely C, Márquez L, Calafat M, González-Muñoza C, Cañete F, Mesonero F, Guardiola J, Garcia-Planella E, Mañosa M, Domènech E. Clinical and endoscopic outcomes of patients with colonic Crohn's disease treated with 5-aminosalicylates as monotherapy. Gastroenterol Hepatol 2023; 46:164-170. [PMID: 36179946 DOI: 10.1016/j.gastrohep.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/05/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND In spite of the lack of evidence regarding the clinical benefits of oral 5-aminosalicylic acid (5-ASA) compounds in Crohn's disease (CD), these drugs are frequently used in daily clinical practice, particularly for colonic CD. Our aim is to assess the use and clinical outcomes of 5-ASA of those patients with colonic CD treated with 5-ASA as monotherapy. METHODS Patients diagnosed with isolated colonic CD and treated with 5-ASA but never exposed to immunosuppressants or biologicals were identified from the local databases of five referral centres. A retrospective review of clinical and endoscopic outcomes was performed. RESULTS Out of 545 patients with isolated colonic CD, 106 (19%) were treated with oral 5-ASA in monotherapy as maintenance therapy. The median follow-up was 144 months (interquartile range [IQR], 48-234). Almost all of the patients (92%) presented an inflammatory pattern and 11% developed perianal disease. Half of the patients had already received 5-ASA at diagnosis, and the median duration of 5-ASA treatment was 107 months (IQR 22.5-187). Endoscopic remission, as defined by the absence of ulcers at the last complete colonoscopy, was observed in 65% of those patients undergoing at least one colonoscopy during follow-up. Male gender and extraintestinal manifestations were associated with a lower likelihood of achieving endoscopic remission. Nine patients required colectomy, but mostly soon after CD diagnosis. CONCLUSIONS 5-ASA seems to be of benefit in the long-term in one fifth of patients with colonic CD as the only maintenance therapy and should be considered in fragile patients with Crohn's colitis.
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Affiliation(s)
- Edgar Castillo-Regalado
- Department of Gastroenterology, Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain
| | - Raquel Ríos
- Department of Gastroenterology, Hospital Ramón y Cajal, Madrid, Spain
| | - Clàudia Aràjol
- Department of Gastroenterology, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Catalonia, Spain
| | - Cristina Gely
- Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain
| | - Lucía Márquez
- Department of Gastroenterology, Hospital del Mar, Barcelona, Catalonia, Spain
| | - Margalida Calafat
- Department of Gastroenterology, Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain
| | - Carlos González-Muñoza
- Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain
| | - Fiorella Cañete
- Department of Gastroenterology, Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain
| | | | - Jordi Guardiola
- Department of Gastroenterology, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Catalonia, Spain
| | - Esther Garcia-Planella
- Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain
| | - Míriam Mañosa
- Department of Gastroenterology, Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain
| | - Eugeni Domènech
- Department of Gastroenterology, Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.
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Aràjol C, Aira Gómez A, González-Suárez B, Casals-Pascual C, Martí Martí S, Domínguez Luzón MÁ, Soriano A, Guardiola Capón J. Donor selection for faecal microbiota transplantation. Consensus document of the Catalan Society of Gastroenterology and the Catalan Society of Infectious Diseases and Clinical Microbiology. Gastroenterol Hepatol 2020; 44:175-180. [PMID: 33309073 DOI: 10.1016/j.gastrohep.2020.07.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/29/2020] [Accepted: 07/13/2020] [Indexed: 01/06/2023]
Abstract
Faecal microbiota transplantation (FMT) is an effective and safe treatment of recurrent Clostridioides difficile infection. It is essential to make every effort to perform FMT rigorously and based on scientific knowledge. Selection of the faecal microbiota donor is a key part of the process to ensure recipient safety. Protocols of action must be implemented that allow clinicians to act with the maximum guarantees and to minimise the risks of the procedure. In this regard, a multidisciplinary working group has been set up with the aim of establishing recommendations for selecting the faecal microbiota donor.
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Affiliation(s)
- Clàudia Aràjol
- Servicio de Aparato Digestivo, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, España.
| | - Andrea Aira Gómez
- Servicio de Enfermedades Infecciosas, Hospital Clínic, Barcelona, España
| | | | | | - Sara Martí Martí
- Servicio de Microbiología Clínica, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, España
| | - M Ángeles Domínguez Luzón
- Servicio de Microbiología Clínica, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, España
| | - Alex Soriano
- Servicio de Microbiología Clínica, Hospital Clínic, Barcelona, España
| | - Jordi Guardiola Capón
- Servicio de Aparato Digestivo, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, España
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