Abstract
Topical 5-aminosalicylic acid (5-ASA) and corticosteroids are used frequently in the treatment of active distal ulcerative colitis (UC). Our study aimed to determine the efficacy and safety of different topical drugs used to treat active distal UC. A random-effects model within a Bayesian framework was utilized to compare treatment effects and safety as odds ratios (ORs) with corresponding 95% credible intervals (CrI). The surface under the cumulative ranking area (SUCRA) and median rank (MR) with corresponding 95% CrI were calculated to rank the treatment outcomes. In the induction of clinical and endoscopic remission, most regimens showed significant advantages over placebo except topical budesonide 0.5 mg/d and hydrocortisone 100 mg/d. According to SUCRA and MR values, rectal 5-ASA 1.5 to 2.0 g/d + Beclomethasone dipropionate (BDP) 3 mg/d rendered the highest probability of being the best regimen to achieve clinical and endoscopic remission, followed by the separate use of 5-ASA 4 g/d and BDP 3 mg/d. The occurrence of adverse events was not significantly different between each treatments and placebo. In conclusion, the combined use of topical 5-ASA and BDP proved to be the best choice for active distal UC and further well-designed researches are warranted to assess its efficacy and safety.
Highlights
Ulcerative colitis (UC) is characterized by diffuse and continuous inflammation of the colon
The results showed that topical 5-aminosalicylic acid (5-ASA) 1.5 to 2.0 g/d +Beclomethasone dipropionate (BDP) 3 mg/d rendered the highest probability of being the best regimen to induce clinical and endoscopic remission in active distal ulcerative colitis (UC) patients compared with placebo
The efficacy and safety of 5-ASA were consistent with the guidelines for UC clinical practice published by the American College of Gastroenterology[51], which suggested that topical 5-ASA at different doses (1–4 g) are efficacious to induce remission in active distal UC
Summary
Ulcerative colitis (UC) is characterized by diffuse and continuous inflammation of the colon. Patients had limited distal colon inflammation (
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