Mesalamine for Recurrent Diverticulitis Prevention: Results from Phase 3 Controlled Trials
the MPR take:
Currently there is no treatment for the prevention of diverticulitis recurrence, although there is preliminary evidence suggesting that mesalamine may be effective for diverticular disease. Two identical but separate randomized, double-blind, placebo-controlled, multicenter Phase 3 studies of 590 (PREVENT1) and 592 (PREVENT2) adults patients with ≥1 episodes of acute diverticulitis in the previous 24 months that resolved sans surgery, sought to evaluate mesalamine (1.2g, 2.4g, or 4.8g) vs. placebo once daily for 104 weeks for diverticulitis recurrence. Among patients in the PREVENT1 trial, 53–63% of the mesalamine patients did not have disease recurrence at Week 104 vs. 65% of the placebo group; in PREVENT2, 59–69% of mesalamine patients did not have diverticulitis recurrence by Week 104 vs. 68% of placebo patients. Mesalamine also had no effect on time to recurrence or reduction of the proportion of patients requiring surgery. Thus, mesalamine is not recommended for this treatment, the authors conclude.
Background & Aims: No therapy has been proven to prevent the recurrence of diverticulitis. Mesalamine has shown efficacy in preventing relapse in inflammatory bowel disease, and there is preliminary evidence that it might be effective for diverticular disease.
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