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Long-term clinical outcomes and factors predictive of relapse after 5-aminosalicylate or sulfasalazine therapy in patients with intestinal Behcet disease

Authors
 Jung, Yoon Suk  ;  Hong, Sung Pil  ;  Kim, Tae Il  ;  Kim, Won Ho  ;  Cheon, Jae Hee 
Citation
 JOURNAL OF CLINICAL GASTROENTEROLOGY, Vol.46(5) : 38-45, 2012 
Journal Title
 JOURNAL OF CLINICAL GASTROENTEROLOGY 
ISSN
 0192-0790 
Issue Date
2012
MeSH
Adult ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use* ; Behcet Syndrome/drug therapy* ; Behcet Syndrome/prevention & control ; C-Reactive Protein/analysis ; Female ; Humans ; Intestinal Diseases/drug therapy* ; Intestinal Diseases/prevention & control ; Male ; Mesalamine/therapeutic use* ; Middle Aged ; Predictive Value of Tests ; Prognosis ; Proportional Hazards Models ; Secondary Prevention ; Sulfasalazine/therapeutic use* ; Time Factors ; Treatment Outcome
Keywords
intestinal Behcet disease ; 5-aminosalicylic acid ; sulfa-salazine ; clinical relapse
Abstract
BACKGROUND: Currently, 5-aminosalicylic acid (5-ASA)/sulfasalazine is used to empirically treat patients with intestinal Behcet disease (BD) without clear clinical evidence. In this study, we investigated long-term clinical outcomes and predictors of clinical relapse in patients with intestinal BD receiving 5-ASA/sulfasalazine maintenance therapy. METHODS: We reviewed the medical records of all the patients with intestinal BD, who received 5-ASA/sulfasalazine therapy in a single tertiary academic medical center between March 1986 and January 2011. The cumulative probabilities of clinical relapse after remission were calculated using the Kaplan-Meier method. Predictors of clinical relapse were identified by univariate analysis using the log-rank test and by multivariate analysis using Cox proportional hazards regression models. RESULTS: Among the 143 patients enrolled, 46 (32.2%) had a clinical relapse while they were being treated with 5-ASA/sulfasalazine therapy. The cumulative relapse rates at 1, 3, 5, and 10 years after remission were 8.1%, 22.6%, 31.2%, and 46.7%, respectively. By multivariate analysis, a younger age (<35 y) at the time of diagnosis, higher C-reactive protein level (≥1.5 mg/dL), and a higher disease activity index for intestinal Behcet disease score (≥60) at the time of 5-ASA/sulfasalazine initiation were independent predictors of relapse in patients with intestinal BD receiving 5-ASA/sulfasalazine maintenance therapy. CONCLUSIONS: This study has shown that 5-ASA/sulfasalazine therapy has a positive effect in maintaining remission in patients with intestinal BD. However, a younger age (<35 y), higher C-reactive protein level (≥1.5 mg/dL), and a higher disease activity index for intestinal Behcet disease score (≥60) were associated with a poor response to 5-ASA/sulfasalazine therapy, making careful observation and intensive treatment necessary in these risk groups.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00004836-201205000-00002&LSLINK=80&D=ovft
DOI
22298088
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Won Ho(김원호) ORCID logo https://orcid.org/0000-0002-5682-9972
Kim, Tae Il(김태일) ORCID logo https://orcid.org/0000-0003-4807-890X
Jung, Yoon Suk(정윤숙)
Cheon, Jae Hee(천재희) ORCID logo https://orcid.org/0000-0002-2282-8904
Hong, Sung Pil(홍성필)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/90683
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