5-Aminosalicylic acid intolerance is associated with a risk of adverse clinical outcomes and dysbiosis in patients with ulcerative colitis
Background/Aims 5-Aminosalicylic acid (ASA) causes intolerance reactions in some patients. This study was performed to examine the prognosis of patients with ulcerative colitis (UC) and 5-ASA intolerance, and to evaluate the potential interaction between 5-ASA intolerance and the intestinal microbio...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Korean Association for the Study of Intestinal Diseases
2020-01-01
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| Series: | Intestinal Research |
| Subjects: | |
| Online Access: | http://www.irjournal.org/upload/pdf/ir-2019-00084.pdf |
| _version_ | 1818694236064710656 |
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| author | Shinta Mizuno Keiko Ono Yohei Mikami Makoto Naganuma Tomohiro Fukuda Kazuhiro Minami Tatsuhiro Masaoka Soichiro Terada Takeshi Yoshida Keiichiro Saigusa Norimichi Hirahara Hiroaki Miyata Wataru Suda Masahira Hattori Takanori Kanai |
| author_facet | Shinta Mizuno Keiko Ono Yohei Mikami Makoto Naganuma Tomohiro Fukuda Kazuhiro Minami Tatsuhiro Masaoka Soichiro Terada Takeshi Yoshida Keiichiro Saigusa Norimichi Hirahara Hiroaki Miyata Wataru Suda Masahira Hattori Takanori Kanai |
| author_sort | Shinta Mizuno |
| collection | DOAJ |
| description | Background/Aims 5-Aminosalicylic acid (ASA) causes intolerance reactions in some patients. This study was performed to examine the prognosis of patients with ulcerative colitis (UC) and 5-ASA intolerance, and to evaluate the potential interaction between 5-ASA intolerance and the intestinal microbiota. Methods We performed a retrospective cohort study of patients with UC who visited participating hospitals. The primary endpoint was to compare the incidence of hospitalization within 12 months between the 5-ASA intolerance group and the 5-ASA tolerance group. The secondary endpoint was to compare the risk of adverse clinical outcomes after the start of biologics between the 2 groups. We also assessed the correlation between 5-ASA intolerance and microbial change in an independently recruited cohort of patients with UC. Results Of 793 patients, 59 (7.4%) were assigned to the 5-ASA intolerance group and 734 (92.5%) were assigned to the 5-ASA tolerance group. The admission rate and incidence of corticosteroid use were significantly higher in the intolerance than tolerance group (P< 0.001). In 108 patients undergoing treatment with anti-tumor necrosis factor biologics, 5-ASA intolerance increased the incidence of additional induction therapy after starting biologics (P< 0.001). The 5-ASA intolerance group had a greater abundance of bacteria in the genera Faecalibacterium, Streptococcus, and Clostridium than the 5-ASA tolerance group (P< 0.05). Conclusions In patients with UC, 5-ASA intolerance is associated with a risk of adverse clinical outcomes and dysbiosis. Bacterial therapeutic optimization of 5-ASA administration may be important for improving the prognosis of patients with UC. |
| first_indexed | 2024-12-17T13:26:22Z |
| format | Article |
| id | doaj.art-fb5d10fb084c4617ae6c56bef7201123 |
| institution | Directory Open Access Journal |
| issn | 1598-9100 2288-1956 |
| language | English |
| last_indexed | 2024-12-17T13:26:22Z |
| publishDate | 2020-01-01 |
| publisher | Korean Association for the Study of Intestinal Diseases |
| record_format | Article |
| series | Intestinal Research |
| spelling | doaj.art-fb5d10fb084c4617ae6c56bef72011232022-12-21T21:46:43ZengKorean Association for the Study of Intestinal DiseasesIntestinal Research1598-91002288-19562020-01-01181697810.5217/ir.2019.000848065-Aminosalicylic acid intolerance is associated with a risk of adverse clinical outcomes and dysbiosis in patients with ulcerative colitisShinta Mizuno0Keiko Ono1Yohei Mikami2Makoto Naganuma3Tomohiro Fukuda4Kazuhiro Minami5Tatsuhiro Masaoka6Soichiro Terada7Takeshi Yoshida8Keiichiro Saigusa9Norimichi Hirahara10Hiroaki Miyata11Wataru Suda12Masahira Hattori13Takanori Kanai14 Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan Endoscopy Center, Edogawa Hospital, Tokyo, Japan Department of Gastroenterology and Hepatology, Saitama Medical Center, Saitama, Japan Department of Gastroenterology and Hepatology, Tokyo Saiseikai Central Hospital, Tokyo, Japan Department of Health Policy and Management, Keio University School of Medicine, Tokyo, Japan Department of Health Policy and Management, Keio University School of Medicine, Tokyo, Japan Laboratory for Microbiome Sciences, RIKEN Center for Integrative Medical Sciences, Kanagawa, Japan Laboratory for Microbiome Sciences, RIKEN Center for Integrative Medical Sciences, Kanagawa, Japan Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, JapanBackground/Aims 5-Aminosalicylic acid (ASA) causes intolerance reactions in some patients. This study was performed to examine the prognosis of patients with ulcerative colitis (UC) and 5-ASA intolerance, and to evaluate the potential interaction between 5-ASA intolerance and the intestinal microbiota. Methods We performed a retrospective cohort study of patients with UC who visited participating hospitals. The primary endpoint was to compare the incidence of hospitalization within 12 months between the 5-ASA intolerance group and the 5-ASA tolerance group. The secondary endpoint was to compare the risk of adverse clinical outcomes after the start of biologics between the 2 groups. We also assessed the correlation between 5-ASA intolerance and microbial change in an independently recruited cohort of patients with UC. Results Of 793 patients, 59 (7.4%) were assigned to the 5-ASA intolerance group and 734 (92.5%) were assigned to the 5-ASA tolerance group. The admission rate and incidence of corticosteroid use were significantly higher in the intolerance than tolerance group (P< 0.001). In 108 patients undergoing treatment with anti-tumor necrosis factor biologics, 5-ASA intolerance increased the incidence of additional induction therapy after starting biologics (P< 0.001). The 5-ASA intolerance group had a greater abundance of bacteria in the genera Faecalibacterium, Streptococcus, and Clostridium than the 5-ASA tolerance group (P< 0.05). Conclusions In patients with UC, 5-ASA intolerance is associated with a risk of adverse clinical outcomes and dysbiosis. Bacterial therapeutic optimization of 5-ASA administration may be important for improving the prognosis of patients with UC.http://www.irjournal.org/upload/pdf/ir-2019-00084.pdf5-aminosalicylic acidcolitis, ulcerativeprognosisdysbiosis |
| spellingShingle | Shinta Mizuno Keiko Ono Yohei Mikami Makoto Naganuma Tomohiro Fukuda Kazuhiro Minami Tatsuhiro Masaoka Soichiro Terada Takeshi Yoshida Keiichiro Saigusa Norimichi Hirahara Hiroaki Miyata Wataru Suda Masahira Hattori Takanori Kanai 5-Aminosalicylic acid intolerance is associated with a risk of adverse clinical outcomes and dysbiosis in patients with ulcerative colitis Intestinal Research 5-aminosalicylic acid colitis, ulcerative prognosis dysbiosis |
| title | 5-Aminosalicylic acid intolerance is associated with a risk of adverse clinical outcomes and dysbiosis in patients with ulcerative colitis |
| title_full | 5-Aminosalicylic acid intolerance is associated with a risk of adverse clinical outcomes and dysbiosis in patients with ulcerative colitis |
| title_fullStr | 5-Aminosalicylic acid intolerance is associated with a risk of adverse clinical outcomes and dysbiosis in patients with ulcerative colitis |
| title_full_unstemmed | 5-Aminosalicylic acid intolerance is associated with a risk of adverse clinical outcomes and dysbiosis in patients with ulcerative colitis |
| title_short | 5-Aminosalicylic acid intolerance is associated with a risk of adverse clinical outcomes and dysbiosis in patients with ulcerative colitis |
| title_sort | 5 aminosalicylic acid intolerance is associated with a risk of adverse clinical outcomes and dysbiosis in patients with ulcerative colitis |
| topic | 5-aminosalicylic acid colitis, ulcerative prognosis dysbiosis |
| url | http://www.irjournal.org/upload/pdf/ir-2019-00084.pdf |
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