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Once daily slow release mesalazine is equivalent to twice daily for the maintenance of remission in ulcerative colitis
Once daily dosing undoubtedly improves compliance, so this study, comparing once daily with twice daily dosing of mesalazine, is encouraging. Patients with mild to moderate acute ulcerative colitis achieving remission in a previous 8-week study of either 2.4 g once daily, 1.2 g twice daily or 4.8 g once daily were entered into the present open-labelled 12-month maintenance trial comparing 1.2 g twice daily with 2.4 g daily. Those failing to respond to the initial 8-week’s treatment were offered a further 8 weeks of 2.4 g twice daily and, if they then achieved remission, were also entered into the maintenance trial. Of 459 patients randomised, 213 required the additional 8 weeks at 4.8 g daily to achieve remission. Adverse events were equally distributed between the two groups. Only one serious adverse event was considered to be related to the study treatment. Remission rates at 12 months were similar for the two doses (see fig), although lower in those who had required a further 8 week’s treatment at high dose to achieve remission. This encouraging result suggests that once daily treatment will soon become standard. See p 893
Reduced defensin expression in ileal Crohn’s disease is secondary to inflammation and independent of NOD2 status
The recent discovery of the link between Crohn’s disease (CD) and a mutation in the NOD2 gene was followed by a report of reduced defensin production in patients with ileal CD with this mutation, an idea further explored in …
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