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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.

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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

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