5-ASAs in Crohn’s Disease: Time to Stop the Salicylate?

Excerpt

Despite accumulating evidence pointing toward their lack of efficacy, the use of 5-aminosalicylates (5-ASA) in Crohn’s disease (CD) remains prevalent, contrary to the recommendations of most national and international guidelines. Cochrane systematic reviews of randomized trials have previously showed no benefit for 5-ASA drugs over placebo for inducing or maintaining remission in CD [1, 2]. Notwithstanding the above, 5-ASAs are one of the most commonly prescribed group of drugs in CD. For example, data from a recent retrospective analysis of a primary care database showed that 44.2% of patients with CD were prescribed a 5-ASA in the UK [3]. Research has focused on whether discontinuing 5-ASAs in those established on immunosuppressive therapy leads to disease exacerbation. Addressing this area has the potential to improve the financial burden on the health economy and reduce patient exposure to unnecessary drugs. …