P0741 Adherence to mesalazine suppositories maintenance treatment in patients with ulcerative proctitis: MESUPO multicenter prospective observational study from GETECCU
R Ferreiro Iglesias, L Nieto García, M L de Castro, P Pérez Galindo, A Hernández Camba, M J García, M Calvo Íñiguez, I Rodríguez-Lago, E Martí, A Iriarte, H Pallarés, C Dueñas Sadornil, L Zabalza San Martín, P Ramirez de la Piscina, L Rodríguez, I Bastón Rey, J Martínez Cadilla, A Álvarez Cancelo, S Porto Silva, Y Zabana, M Barreiro-de Acosta,Abstract
Background
Mesalazine suppositories are recommended in guidelines for the induction and maintenance of remission in patients with ulcerative proctitis (UP). Nevertheless, nonadherence can be frequent and the recommended dose of mesalazine suppositories in maintenance treatment remains unknown. The aim of this study was to determine the frequency of non-adherence to mesalazine suppositories, evaluate potential factors for nonadherence and the impact on quality of life and number of relapses in patients with UP.
Methods
A multicenter, prospective observational study was designed in patients ≥18 years old with UP under maintenance treatment with mesalazine suppositories (Claversal© 500 mg, Pentasa© 1g or Salofalk©1g). We evaluated adherence, sociodemographic data and complications associated with poor adherence at 6 and 12 months. Adherence was assessed by tracking pharmacy refills (medication possession ratio, MPR). We defined good adherence as MPR ≥80% over 12 months. Health-Related Quality of Life (HRQoL) was evaluated using the disease-specific shortened Spanish version of the IBDQ (SIBDQ-9). Relapse was defined as partial Mayo ≥2. Quantitative data were analyzed using Rstudio software (version 2023.12.1 + 402)
Results
A total of 188 patients with mean age 51 were consecutively included across 14 Spanish hospitals (Table 1). Of these, mean MPR was 76% and 56% presented MPR ≥80%. Mean age was higher among patients with MPR ≥80% (p=0.045). A total of 31 patients (16%) had a relapse and 3 (1.6%) patients were hospitalized during the follow-up. Unemployment(OR=5.08, p=0.025), concomitant anal pathology (OR=5.08, p =0.025) and use of corticosteroids during the follow-up (OR=4.25, p=0.041) were associated with better adherence. There were no differences between the different brands and doses of suppositories analyzed. Low adherence was not related with increased number of flares (p=0.927), hospitalizations (p=0.225) or decreased quality of life (p = 0.353) over the 12 months of follow-up.
Conclusion
Almost half of patients with UP on maintenance treatment with mesalazine suppositories have low adherence. Older age, unemployment, use of corticosteroids during the follow-up or the presence of concomitant anal pathology may increase adherence, but poor adherence to mesalazine suppositories was not related with risk of relapse, hospitalizations or worst quality of life.