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

Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

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.