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Background <p>First-line therapy for mild-to-moderate ulcerative colitis is 5-aminosalicylic acid. Optimal timing for the first evaluation after initiation remains unclear. Early follow-up may not reflect efficacy, while delayed assessment could be inefficient. We conducted a prospective observational cohort study to identify the optimal evaluation time after 5-aminosalicylic acid induction in newly diagnosed patients.</p> Methods <p>The cohort included 157 patients at Xijing Hospital. All received standard 5-aminosalicylic acid therapy, grouped by first follow-up timing: 4&#xa0;weeks (W4; N = 41), 8&#xa0;weeks (W8; N = 40), or 12&#xa0;weeks (W12; N = 42). Dose adjustments followed physician assessment. Primary outcome was clinical response/remission rate at Week 12 (Partial Mayo score). Secondary outcomes included inflammatory markers, mucosal healing, and dose adjustments.</p> Results <p>At Week 4, 68.29% of the W4 group achieved early clinical response. 82.93% in the W4 group reduced 5-aminosalicylic acid dosage by Week 4, versus 67.50% in the W8 group by Week 8. Consequently, cumulative 5-ASA exposure was lower in the W4 group. At Week 12, remission rates were similarly high across groups. At 24&#xa0;weeks, long-term outcomes were comparable.</p> Conclusion <p>Follow-up at 4&#xa0;weeks enables timely dose optimization and reduced healthcare costs without compromising 6-month efficacy. Thus, 4&#xa0;weeks may be optimal for first evaluation after starting 5-ASA in mild-to-moderate ulcerative colitis.</p> <p><i>Trial registration</i> This trial was retrospectively registered on ClinicalTrials.gov (NCT06998693) on May 6, 2025.</p>

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What is the optimal timing to assess the effect of 5-ASA in patients with mild-to-moderate ulcerative colitis? A single-center prospective observational study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月27日

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  • Yu Da,
  • Fang Wang,
  • Jiaqi Zhang,
  • Tiantian Zhang,
  • Xiaoning Liu,
  • Jindan He,
  • Yanting Shi,
  • Tong Wu,
  • Jie Liang

摘要

Background

First-line therapy for mild-to-moderate ulcerative colitis is 5-aminosalicylic acid. Optimal timing for the first evaluation after initiation remains unclear. Early follow-up may not reflect efficacy, while delayed assessment could be inefficient. We conducted a prospective observational cohort study to identify the optimal evaluation time after 5-aminosalicylic acid induction in newly diagnosed patients.

Methods

The cohort included 157 patients at Xijing Hospital. All received standard 5-aminosalicylic acid therapy, grouped by first follow-up timing: 4 weeks (W4; N = 41), 8 weeks (W8; N = 40), or 12 weeks (W12; N = 42). Dose adjustments followed physician assessment. Primary outcome was clinical response/remission rate at Week 12 (Partial Mayo score). Secondary outcomes included inflammatory markers, mucosal healing, and dose adjustments.

Results

At Week 4, 68.29% of the W4 group achieved early clinical response. 82.93% in the W4 group reduced 5-aminosalicylic acid dosage by Week 4, versus 67.50% in the W8 group by Week 8. Consequently, cumulative 5-ASA exposure was lower in the W4 group. At Week 12, remission rates were similarly high across groups. At 24 weeks, long-term outcomes were comparable.

Conclusion

Follow-up at 4 weeks enables timely dose optimization and reduced healthcare costs without compromising 6-month efficacy. Thus, 4 weeks may be optimal for first evaluation after starting 5-ASA in mild-to-moderate ulcerative colitis.

Trial registration This trial was retrospectively registered on ClinicalTrials.gov (NCT06998693) on May 6, 2025.