Aminosalicylates are a type of drug often used to manage inflammatory bowel diseases (IBD) like ulcerative colitis (UC). The Crohn’s & Colitis Foundation explains that these therapies, which contain 5-aminosalicylic acid (5-ASA) to reduce intestinal swelling, have been shown to be effective in inducing remission and controlling inflammation in UC. However, despite the efficacy of 5-ASA therapy, treatment adherence is low in adolescents and young adults.
Research Findings: Why Stop 5-ASA?
According to reporting by Healio, researchers wanted to understand how well patients complied with medication. In a study published in the British Journal of General Practice, a research team headed by Nishani Jayasooriya explored oral 5-ASA use in 607 patients with ulcerative colitis over an 18-year period. All patients were between ages ten and 24. The majority of patients were male, and despite the age spread, most were in the young adult category between 18 and 24 years old.
Findings from the study show that a majority of adolescents and young adults discontinue treatment fairly early on. According to the study:
- 25% (in this case, 152 patients) stopped using 5-ASA within just over one month.
- By one year, 69% (419 patients) discontinued 5-ASA treatment within one year.
- The highest rates of discontinuation occurred in the older age range (18-24), though 61% of 10-14 year-olds and 56% of 15-17 year-olds discontinued treatment within one year.
- Mean adherence to treatment was 72% across all age ranges.
The research team found that certain factors correlated with treatment compliance or non-compliance. People who experienced early flare-ups and required corticosteroid use were more likely to adhere to 5-ASA treatment. Alternatively, people who were in the older age group or who did not live in higher socioeconomic areas were less likely to comply.
Ultimately, the research highlights an issue in ulcerative colitis management: those affected are not, and cannot, receive the best care if they are not regularly or properly using their medication. As a result, the researchers suggest that doctors become more educated about the factors associated with treatment non-adherence and perform regular outreach to their patients. This data also suggests that regular follow-up is needed.
About Ulcerative Colitis (UC)
Ulcerative colitis is a chronic inflammatory disease that falls under the umbrella of inflammatory bowel diseases, alongside Crohn’s disease. Adolescents and young adults, as well as people over 60 years old, are at the highest risk of developing ulcerative colitis. It is also more common in those with a family history of IBD or from Ashkenazi Jewish backgrounds. Symptoms may include bloody stool, fatigue, nausea and vomiting, low red blood cell counts (anemia), rashes, joint pain, abdominal cramping, and diarrhea. Treatments such as 5-ASA, corticosteroids, immunomodulators, and antibiotics may be used to manage this condition.