Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2018 Mar;84(3):477-481.
doi: 10.1111/bcp.13462. Epub 2017 Dec 6.

Urinalysis of MMX-mesalazine as a tool to monitor 5-ASA adherence in daily IBD practice

Tessa E H Römkens  1   2 , Rene Te Morsche  1 , Wilbert Peters  1 , David M Burger  3 , Frank Hoentjen  1 , Joost P H Drenth  1
Affiliations
Randomized Controlled Trial

Urinalysis of MMX-mesalazine as a tool to monitor 5-ASA adherence in daily IBD practice

Tessa E H Römkens et al. Br J Clin Pharmacol. 2018 Mar.

Abstract

Adherence is pivotal but challenging in ulcerative colitis (UC) treatment. Many methods to assess adherence are subjective or have limitations. (Nac-)5-aminosalicylic acid (5-ASA) urinalysis by high-performance liquid chromatography (HPLC) seems feasible and reproducible in healthy volunteers. We performed a prospective study in adult quiescent UC patients to evaluate the feasibility of spot (Nac-)5-ASA urinalysis by HPLC to assess adherence in daily inflammatory bowel disease (IBD) care. Twenty-nine patients (51.7% male, mean age 52 ± 11 years) were included (median FU 9 months) and weekly spot urine samples were collected. We found large variation in spot (Nac-)5-ASA urinary excretion that was unrelated to brand, dosing schedule or dosage of 5-ASA. In conclusion, spot (Nac-)5-ASA urinalysis is not applicable to assess 5-ASA adherence in daily IBD care.

Keywords: HPLC; MMX-mesalazine; adherence; compliance; inflammatory bowel disease.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Individual spot (Nac‐)5‐ASA urinary excretion (5‐ASA/mg mmol l−1 creatinine) using different brands and dosages 5‐ASA at screening
Figure 2
Figure 2
(A) Individual (Nac‐)5‐ASA urinary excretion (5‐ASA/mg mmol l−1 creatinine) in 29 UC patients using 2400 mg MMX‐mesalazine. (B) Individual steady state results of (Nac‐)5‐ASA urinary excretion (5‐ASA/mg mmol l−1 creatinine) in 25 healthy volunteers using 2400 mg MMX‐mesalazine
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Kane S, Huo D, Aikens J, Hanauer S. Medication nonadherence and the outcomes of patients with quiescent ulcerative colitis. Am J Med 2003; 114: 39–43. - PubMed
    1. Kane S, Katz S, Jamal MM, Safdi M, Dolin B, Solomon D, et al Strategies in maintenance for patients receiving long‐term therapy (SIMPLE): a study of MMX mesalamine for the long‐term maintenance of quiescent ulcerative colitis. Inflamm Bowel Dis 2012; 18: 1026–1033. - PubMed
    1. Kawakami A, Tanaka M, Nishigaki M, Naganuma M, Iwao Y, Hibi T, et al Relationship between non‐adherence to aminosalicylate medication and the risk of clinical relapse among Japanese patients with ulcerative colitis in clinical remission: a prospective cohort study. J Gastroenterol 2013; 48: 1006–1015. - PubMed
    1. Khan N, Abbas AM, Bazzano LA, Koleva YN, Krousel‐Wood M. Long‐term oral mesalazine adherence and the risk of disease flare in ulcerative colitis: nationwide 10‐year retrospective cohort from the veterans affairs healthcare system. Aliment Pharmacol Ther 2012; 36: 755–764. - PubMed
    1. Mitra D, Hodgkins P, Yen L, Davis KL, Cohen RD. Association between oral 5‐ASA adherence and health care utilization and costs among patients with active ulcerative colitis. BMC Gastroenterol 2012; 12: 132. - PMC - PubMed

Publication types

Substances