Long-Term Use of Mesalamine (Rowasa) Suppositories in Remission Maintenance of Ulcerative Proctitis
- Stephen Hanauer
- Larry I Good
- Michael W Goodman
- Ronald J Pizinger
- Williamson B Strum
- Carl Lyss
- Gregory Haber
- Noel C Williams
- Malcolm Robinson
ABSTRACT
OBJECTIVE:
The purpose of this study was to evaluate the efficacy and safety of a single nightly 500-mg Rowasa (mesalamine) suppository as maintenance therapy for patients with ulcerative proctitis in remission.
METHODS:
In this 24-month, multicenter, double-blind trial, 65 patients with ulcerative proctitis in clinical and endoscopic remission were randomized to receive either a single nightly 500-mg rectal mesalamine (Rowasa) suppository or matching placebo as sole therapy. Efficacy was assessed by time to relapse (defined as rectal bleeding or increase in stool frequency for ≥1 wk and active inflammation upon endoscopy).
RESULTS:
Mean time to relapse was 453.4 days for mesalamine-treated patients and 158.0 days for placebo-treated patients. Survival analysis demonstrated that time to relapse was significantly greater for mesalamine-treated patients than for placebo-treated patients (p < 0.001). In addition, at both 12 and 24 months, the proportion of placebo-treated patients (86% at 12 months and 89% at 24 months) who relapsed was significantly (p≤ 0.001) greater than mesalamine-treated patients (32% and 46%, respectively). No statistically significant differences occurred between treatment groups in the reporting of any particular adverse event or the number of patients reporting adverse events.
CONCLUSIONS:
The results demonstrate that mesalamine suppositories are efficacious, well tolerated, and safe for the long-term maintenance of remission of ulcerative proctitis.
