Pediatric UC: study shows high rate of 5-ASA intolerance

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Takeaway

  • This study found a relatively high incidence of 5-aminosalicylate (5-ASA) intolerance; besides a challenge test, elevation of C-reactive protein (CRP) and positive drug-induced lymphocyte stimulation test (DLST) support diagnosis of 5-ASA intolerance.

Why this matters

  • 5-ASA is widely used as a first-line drug for ulcerative colitis (UC), but medication intolerance can cause exacerbations that mimic disease.

Key results

  • Among 80 children with UC, 11 (13.8%) were diagnosed with 5-ASA intolerance.
  • In patients not receiving corticosteroids, median duration between initiation of 5-ASA and onset of intolerance was 10 d (4-20 d).
  • DLST was positive in 8 of 10 patients in whom it was performed.
  • Exacerbation of colitis symptoms was associated with significant increase in CRP.

Study design

  • Single-center, retrospective review of incidence, symptoms, disease course, and laboratory data of 80 children with UC.
  • Funding: Japanese Ministry of Health, Labor, and Welfare.
Limitations
  • Retrospective, single-center study.