MESALAMINE IN THE PREVENTION OF ENDOSCOPIC RECURRENCE AFTER INTESTINAL RESECTION FOR CROHNS-DISEASE

Background/Aims: Recurrence of lesions of Crohn's disease of the ileum within 1 year after so-called curative resection was well documented by endoscopy in 73%-93% of cases. This study investigated the efficacy of mesalamine in reduction of endoscopic recurrence after surgery, Me thods: In a double-blind, multicenter clinical trial, 87 patients were treated with 3 g/day mesalamine (Pentasa) or with placebo within 1 mo nth after surgery, After 12 months of treatment, severity of endoscopi c lesions was recorded with a five-point score; when it was not possib le to reach the anastomosis by endoscopy, a barium enema was performed . Results: Seventeen clinical relapses (seven in the mesalamine group) were recorded, After 12 months, the endoscopic lesions were less freq uent and less severe in the mesalamine group than were those in the pl acebo group (chi(2), 13.5; P < 0.008), The overall rate of severe recu rrence (score of 3-4 on endoscopy or radiological documentation) was 2 4% in the mesalamine group and 56% in the placebo group (chi(2), 8.57; P < 0.004; difference 32%; 95% confidence interval, 22-52), The odds ratio for active treatment was 4.1, Conclusions: This study shows that mesalamine is useful in decreasing the rate and severity of endoscopi c recurrences after curative surgery for ileal Crohn's disease.