eHealth: Individualization of Mesalazine Treatment Through a Self-managed Web-based Solution in Mild-to-moderate Ulcerative Colitis

Natalia Pedersen, Peter Thielsen, Lars Martinsen, Mette Bennedsen, Anne Haaber, Ebbe Langholz, Zsuzsanna Végh, Dana Duricova, Tine Jess, Sally Bell, Johan Burisch, Pia Munkholm

45 Citations (Scopus)

Abstract

Background: To individualize treatment with mesalazine for ulcerative colitis relapses through a self-managed, web-based solution to optimize the short-term disease course. Methods: Prospective, open-label, web-guided study with 3 months mesalazine therapy among patients with mild-to-moderate ulcerative colitis. Once a week, patients completed the simple clinical colitis activity index (SCCAI) and registered fecal calprotectin (FC) on the web application: www.meza. constant-care.dk. SCCAI and FC were summed and resulted in a total inflammatory burden score (TIBS). Deep remission was defined as SCCAI≤1; FC = 0, and TIBS #1. Results: A total of 95 patients (62% females; median age 45 yr) were included in the study and allocated 4.8 g mesalazine per day. Of these, 82 (86%) patients were adherent to web therapy, completing 3 months of web-guided mesalazine therapy. Of the 82 adherent patients, 72 (88%) continued mesalazine and 10 (12%) needed rescue therapy. From weeks 0 to 12, patients had experienced a significant reduction in mean SCCAI (4.6 versus 1.6, P , 0.001), mean FC (437 versus 195, P , 0.001), and mean TIBS (6.7 versus 2.4, P , 0.001). Based on TIBS values (#1), the dose of mesalazine was reduced to 2.4 g in 25% of patients at week 3 in 50% of subjects at week 5 and in 88% of patients at week 12. Conclusions: Web-guided therapy with mesalazine in mild-to-moderate ulcerative colitis helps to individualize the dose and improve adherence to therapy. The study confirms mesalazine efficacy in mild-to-moderate UC, significantly improving TIBS values in majority of the patients.

Original languageEnglish
JournalInflammatory Bowel Diseases
Volume20
Issue number12
Pages (from-to)2276-2285
Number of pages10
ISSN1078-0998
DOIs
Publication statusPublished - 1 Dec 2014

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