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* = Presenting author

P493 Adding 5-Aminosalicylate to Immunomodulators Showed No Additional Benefit in Crohn's Disease

K.-J. Kim*, M.S. Kwak, J.S. Soh, D.-H. Cho, S.H. Park, J.-S. Byeon, B.D. Ye, S.-J. Myung, D.-H. Yang, S.-K. Yang, J.H. Kim

University of Ulsan College of Medicine, Gastroenterology, Seoul, South Korea

Background

The use of 5-aminosalicylate (5-ASA) in Crohn's disease (CD) has provoked many debates in recent years. However, a significant number of doctors used 5-ASA as combination with immunomodulators (IMM) because of lack of evidence that 5-ASA has no additional benefit over IMM monotherapy for control of CD. This study was conducted to investigate whether concomitant therapy with both 5-ASA and IMM is better than IMM monotherapy in terms of the long term efficacy in CD.

Methods

Between January 1991 and May 2014.a total of 106 patients treated with IMMs only were identified, and were compared with 318 matched patients (1:3) treated with concomitant therapy during the same periods retrospectively. All the patients have been on IMMs or IMMs with 5-ASA more than 3 months at Asan medical center, Seoul, Korea. Kaplane Meier analysis was used to estimate the cumulative probability of receiving oral corticosteroids, anti-TNF agents, resectional surgery, and disease- related hospitalization.

Results

The median length of follow-up for patients was 57.6 months (Range, 192.0 or IQR, 28.8). The cumulative probabilities of steroid use were 0.3%, 24.9%, and 75.8% in 5-ASA+IMM group, and 0%, 31.2% and 87.8% in IMM only group at 1, 5, and 10 years respectively (p = 0.187). And, the cumulative probabilities of anti-TNF use at 1, 5, and 10 years were 0 %, 12.9 %, and 49.4 % in 5-ASA+IMM group, and 0 %, 20.6% and 63.2% in IMM only group (p = 0.107) respectively. Furthermore, surgical resection rate and disease related hospitalization rate were comparable between the groups. Drug-related adverse events occurred similarly in the both groups (p = 0.799).

Conclusion

Adding 5-ASA to IMM showed no additional benefit in terms of steroid use, anti-TNF use, resectional surgery and disease related hospitalization.