Requerimientos terapéuticos en el tratamiento de mantenimiento de la proctitis ulcerosa

M. Calafat , T. Lobatón , M. Mañosa , M. Larraín , N. Caballero , E. Cabré , E. Domènech
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Abstract

Introduction

In population-based studies, ulcerative proctitis (UP) accounts for more than 25% of ulcerative colitis (UC) patients and presents distinctive clinical outcomes and therapeutic approaches as compared to left-sided and extensive UC. Our aim was to describe the different therapeutic approaches and health resources used in patients with UP in clinical remission.

Material and methods

We performed a retrospective observational study including patients with UP that were followed in our Hospital Universitari Germans Trias i Pujol between 1989-2014. Clinical information and the different treatments for the maintenance of remission were recorded, including galenical formulation.

Results

A total of 101 patients with UP were included. Median time of follow up was 8 years (IQR 3-14). Most patients were treated with topical mesalazine (especially suppositories) (89%); followed by oral mesalazine (55%). The 33% of patients underwent combined therapy with oral and topical mesalazine. Another 12% were treated with topical steroids for maintenance therapy and 3% of patients required thiopurines. The 10% of patients attended to Emergency Service and 4% were hospitalized for disease activity within follow-up. None of them required colectomy.

Conclusions

Topical mesalazine is the most used maintenance treatment in UP patients in our clinical practice, suggesting both a good acceptance by patients and a high degree of confidence for doctors. UP is associated with a low requirement of health resources, although studies focused on the quality of life are needed.

溃疡性直肠炎维持治疗的治疗要求
在基于人群的研究中,溃疡性直肠炎(UP)占溃疡性结肠炎(UC)患者的25%以上,与左侧和广泛性UC相比,溃疡性直肠炎呈现出独特的临床结果和治疗方法。我们的目的是描述不同的治疗方法和用于临床缓解的UP患者的健康资源。材料和方法我们进行了一项回顾性观察研究,包括1989-2014年在我们的德国大学特里亚斯普约尔医院随访的UP患者。记录临床信息和维持缓解的不同治疗方法,包括盖伦制剂。结果共纳入101例UP患者。中位随访时间为8年(IQR 3-14)。大多数患者外用美沙拉嗪(尤其是栓剂)治疗(89%);其次是口服美沙拉嗪(55%)。33%的患者接受口服和外用美沙拉嗪联合治疗。另外12%的患者接受局部类固醇维持治疗,3%的患者需要硫嘌呤。10%的患者就诊于急诊服务,4%的患者在随访期间因疾病活动而住院。他们都不需要结肠切除术。结论临床应用美沙拉嗪是临床上最多的UP患者维持治疗方法,患者接受度好,医生信心高。UP与卫生资源需求低有关,尽管需要对生活质量进行重点研究。
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