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Systematic review: safety of mesalazine in ulcerative colitis

氨基水杨酸 医学 溃疡性结肠炎 不利影响 内科学 胃肠病学 不良事件报告系统 入射(几何) 加药 肾功能 疾病 光学 物理
作者
Priya Sehgal,Jean‐Frédéric Colombel,Aiya Aboubakr,Neeraj Narula
出处
期刊:Alimentary Pharmacology & Therapeutics [Wiley]
卷期号:47 (12): 1597-1609 被引量:134
标识
DOI:10.1111/apt.14688
摘要

Summary Background Mesalazine is the most commonly prescribed medication for mild to moderate ulcerative colitis. It is generally well tolerated with some reported side effects. Aim To summarise adverse drug events to mesalazine and recommend techniques for management. Furthermore, to determine if there is a dose‐dependent relationship between high (>2.4 g/day) vs low dosing (≤2.4 g/day) and occurrence of adverse drug events. Methods A literature search for relevant studies from inception to 1 December 2017 of the MEDLINE database was conducted. Two reviewers screened all titles identified. Data obtained from randomised controlled trials was used to estimate incidence rates of each adverse event. Two reviewers independently assessed methodological risk of bias and performed data extraction. Results 3581 articles were initially considered. Of these, 3573 were screened, 622 reviewed and 91 included. Adverse events attributed to mesalazine included inflammatory reactions, pancreatitis, cardiotoxicity, hepatotoxicity, musculoskeletal complaints, respiratory symptoms, nephropathies and sexual dysfunction. There does not appear to be a dose‐dependent relationship of mesalazine and occurrence of adverse events. Conclusion Patients on mesalazine should be monitored for worsening of ulcerative colitis and development of new onset organ dysfunction. High‐dose mesalazine appears to have similar safety profile as low dose, and is not associated with greater risk of adverse events. Prior to placing a patient on mesalazine, baseline liver and renal function should be evaluated. Renal function should be periodically assessed, whereas other testing should be performed depending on development of symptoms.
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