The use of 5-aminosalicylate for patients with Crohn's disease in a prospective European inception cohort with 5 years follow-up - an Epi-IBD study

BACKGROUND: The lack of scientific evidence regarding the effectiveness of 5-aminosalicylate in patients with Crohn's disease is in sharp contrast to its widespread use in clinical practice.

AIMS: The aim of the study was to investigate the use of 5-aminosalicylate in patients with Crohn's disease as well as the disease course of a subgroup of patients who were treated with 5-aminosalicylate as maintenance monotherapy during the first year of disease.

METHODS: In a European community-based inception cohort, 488 patients with Crohn's disease were followed from the time of their diagnosis. Information on clinical data, demographics, disease activity, medical therapy and rates of surgery, cancers and deaths was collected prospectively. Patient management was left to the discretion of the treating gastroenterologists.

RESULTS: Overall, 292 (60%) patients with Crohn's disease received 5-aminosalicylate period during follow-up for a median duration of 28 months (interquartile range 6-60). Of these, 78 (16%) patients received 5-aminosalicylate monotherapy during the first year following diagnosis. Patients who received monotherapy with 5-aminosalicylate experienced a mild disease course with only nine (12%) who required hospitalization, surgery, or developed stricturing or penetrating disease, and most never needed more intensive therapy. The remaining 214 patients were treated with 5-aminosalicylate as the first maintenance drug although most eventually needed to step up to other treatments including immunomodulators (75 (35%)), biological therapy (49 (23%)) or surgery (38 (18%)).

CONCLUSION: In this European community-based inception cohort of unselected Crohn's disease patients, 5-aminosalicylate was commonly used. A substantial group of these patients experienced a quiescent disease course without need of additional treatment during follow-up. Therefore, despite the controversy regarding the efficacy of 5-aminosalicylate in Crohn's disease, its use seems to result in a satisfying disease course for both patients and physicians.

Media Type:

Electronic Article

Year of Publication:


Contained In:

United European gastroenterology journal - Vol. 8, No. 8 (2020), p. 949-960




Burisch, Johan
Bergemalm, Daniel
Halfvarson, Jonas
Domislovic, Viktor
Krznaric, Zeljko
Goldis, Adrian
Dahlerup, Jens F
Oksanen, Pia
Collin, Pekka
de Castro, Luisa
Hernandez, Vicent
Turcan, Svetlana
Belousova, Elena
D'Incà, Renata
Sartini, Alessandro
Valpiani, Daniela
Giannotta, Martina
Misra, Ravi
Arebi, Naila
Duricova, Dana
Bortlik, Martin
Gatt, Kelly
Ellul, Pierre
Pedersen, Natalia
Kjeldsen, Jens
Andersen, Karina W
Andersen, Vibeke
Katsanos, Konstantinos H
Christodoulou, Dimitrios K
Sebastian, Shaji
Barros, Luisa
Magro, Fernando
Midjord, Jóngerð Mm
Nielsen, Kári R
Salupere, Riina
Kievit, Hendrika Al
Kiudelis, Gediminas
Kupčinskas, Juozas
Fumery, Mathurin
Gower-Rousseau, Corinne
Kaimakliotis, Ioannis P
Schwartz, Doron
Odes, Selwyn
Lakatos, Laszlo
Lakatos, Peter L
Langholz, Ebbe
Munkholm, Pia
Epi-IBD group




Disease course
Journal Article
Population-based cohort


Date Revised 08.12.2020

published: Print-Electronic

Citation Status In-Data-Review

Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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