Once-daily versus multiple-daily mesalamine for patients with ulcerative colitis: a meta-analysis

Tong JL et al. – Once–daily (OD) mesalamine is as effective and has a comparable safety profile as multiple–daily (MD) regimens for the maintenance treatment of ulcerative colitis (UC), and is even more effective for inducing remission in active UC.

Methods

• Electronic databases up to July 2011 were searched for related studies evaluating the efficacy of OD vs MD for treatment of UC.
• Only randomized controlled trials (RCTs) were considered eligible.
• Remission rates or relapse rates were analyzed using intention-to-treat (ITT) and per-protocol (PP) analysis.
• Pooled relative risk (RR) and 95% confidence interval (CI) were calculated.
• Publication bias was assessed with a funnel plot.

Results

• Overall 10 RCTs including 9 full-text manuscripts and one abstract met the inclusion criteria.
• OD dosing of mesalamine was shown to be as effective as MD dosing for the maintenance of clinical remission in patients with quiescent UC (RR = 1.00, 95% CI 0.89–1.12) by ITT analysis.
• For active UC, a mild but significant benefit was achieved by OD dosing compared with MD dosing (RR = 0.80, 95% CI 0.64–0.99).
• Total adverse events were similar using OD and MD mesalamine in quiescent UC (RR = 1.06, 95% CI 0.93–1.20).
• Compliance with OD was slightly better than with MD (RR = 0.92, 95% CI 0.82–1.03).

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