Once daily versus three times daily mesalazine granules in active ulcerative colitis : A double-blind, double-dummy, randomised, non-inferiority trial
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Date
2009-02
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Abstract
Objectives: To determine the therapeutic equivalence and safety of once daily (OD) versus three times daily (TID) dosing of a total daily dose of 3 g Salofalk (mesalazine) granules in patients with active ulcerative colitis. Design: A randomised, double-blind, double-dummy, parallel group, multicentre, international, phase III noninferiority study. Setting: 54 centres in 13 countries. Patients: 380 patients with confirmed diagnosis of established or first attack of ulcerative colitis (clinical activity index (CAI)>4 and endoscopic index ≥ 4 at baseline) were randomised and treated. Interventions: 8-week treatment with either 3 g OD or 1 g TID mesalazine granules. Main outcome measures: Clinical remission (CAI ≤ 4) at study end. Results: 380 patients were evaluable for efficacy and safety by intention-to-treat (ITT); 345 for per protocol (PP) analysis. In the ITT population, 79.1% in the OD group (n = 191) and 75.7% in the TID group (n = 189) achieved clinical remission (p<0.0001 for non-inferiority). Significantly more patients with proctosigmoiditis achieved clinical remission in the OD group (86%; n = 97) versus the TID group (73%; n = 100; p = 0.0298). About 70% of patients in both treatment groups achieved endoscopic remission, and 35% in the OD group and 41% in the TID group achieved histological remission. About 80% of all patients preferred OD dosing. Similar numbers of adverse events occurred in 55 patients (28.8%) in the OD group and in 61 patients (32.3%) in the TID group, indicating that the two dosing regimens were equally safe and well tolerated. Conclusions: OD 3 g mesalazine granules are as effective and safe as a TID 1 g schedule. With respect to the best possible adherence of patients to the treatment, OD dosing of mesalazine should be the preferred application mode in active ulcerative colitis. ClinicalTrials.gov Identifier: NCT00449722.
Description
A list of investigators of the International Salofalk OD Study Group is given in the appendix. Investigators from Latvia are: Jelena Derova, Aleksejs Derovs, Juris Pokrotnieks, Aldis Pukitis, Mairita Ergle.
Keywords
3.2 Clinical medicine, 1.1. Scientific article indexed in Web of Science and/or Scopus database, Gastroenterology
Citation
Kruis, W, Kiudelis, G, Rácz, I, Gorelov, A, Pokrotnieks, J, Horynski, M, Batovsky, M, Kykal, J, Boehm, S, Greinwald, R & Mueller, R 2009, 'Once daily versus three times daily mesalazine granules in active ulcerative colitis : A double-blind, double-dummy, randomised, non-inferiority trial', Gut, vol. 58, no. 2, pp. 233-240. https://doi.org/10.1136/gut.2008.154302