Multi-Matrix 5-Aminosalicylic Acid Efficacy in Induction of Remission in Mild-to-Moderate Ulcerative Colitis: A Systematic Review

Background and Aim: The development of new technologies for ulcerative colitis such as the matrix form of 5-aminosalicylic acid or mesalazine has already shown efficacy over placebo, but not over coated tablet form, which is usually used in clinical protocols for this disease management. Thus, this trial aimed at carrying out a systematic review to gather evidence that can reveal pre-eminence or equivalence in efficacy and safety of these two pharmaceutical forms in induction of remission in mild to moderate ulcerative colitis. Methods: Two independent researchers using Pubmed, Embase, Web of Science, Clinical Trials, Scopus and Science Direct databases and manual search selected eligible randomized clinical trials according to some preestablished inclusion criteria. This research was carried out from July 2016 to April 2019 without limitation of time interval or language, using clinical and endoscopic remission rates as primary endpoints of analysis. Results: Three studies met inclusion criteria and results have demonstrated that similar levels of endoscopic remission were achieved in both forms of the drug. However, clinical remission rates have suggested better results when mesalazine matrix was used. On the other hand, adverse effects were similar in both formulations, with headache and gastrointestinal disorders as the most representative ones. Conclusion: It was concluded that there are insufficient clinical studies to demonstrate the superiority of 5-ASA multi-matrix when compared with coated tablet during ulcerative colitis treatment. Consequently, it requires further clinical studies to add a deeper discussion on choosing a better therapy that can handle with this kind of disease.