微生态制剂枯草杆菌、肠球菌二联活菌肠溶胶囊治疗溃疡性结肠炎58例

目的:观察微生态制剂枯草杆菌、肠球菌二联活菌肠溶胶囊对轻、中度溃疡性结肠炎(Ulcerative colitis,UC)的疗效.方法:本研究收集我科2年住院治疗的轻、中度UC患者139例,按随机、对照分为美沙拉嗪治疗组81人与枯草杆菌、肠球菌二联活菌肠溶胶囊+美沙拉嗪治疗组58人,比较两组在达到缓解时间、缓解率、维持缓解时间、复发率等方面的差异,并对结果进行统计学分析.结果:枯草杆菌、肠球菌二联活菌肠溶胶囊+美沙拉嗪与美沙拉嗪相比,两组在缓解率、维持缓解时间、复发率的比较,枯草杆菌、肠球菌二联活菌肠溶胶囊+美沙拉嗪组缓解率、维持缓解时间、复发率方面差异有统计学意义(x2=4.481,F=3.435,x2=4.757,均P<0.05);达到缓解时间的比较,差异无统计学意义(P>0.05).结论:在治疗轻、中度UC中,枯草杆菌、肠球菌二联活菌肠溶胶囊+美沙拉嗪与美沙拉嗪相比,具有缓解率高、维持缓解时间长、复发率低等优点.     

奥沙拉秦钠胶囊和柳氮磺胺吡啶片治疗溃疡性结肠炎的随机对照研究

目的评价奥沙拉秦钠胶囊治疗溃疡性结肠炎(UC)的临床疗效与安全性.方法采用随机对照试验,将符合入选标准的UC患者135例,分成治疗组105例,对照组30例.治疗组奥沙拉秦钠胶囊1 g,3次/d,餐中服用;对照组柳氮磺胺吡啶片(SASP)1.0 g,4次/d,餐后服用;疗程均为4周.结果治疗组和对照组的临床疗效分别为86.0%和76.7%.腹泻、腹痛、黏液血便总有效率,在治疗组中分别为85.6%、91.3%、92.5%;对照组中分别为84.0%、90.0%、68.0%.黏液血便改善治疗组较对照组为优(P＜0.05).结肠镜下疗效观察治疗组显著优于对照组(P＜0 01),其有效率分别为79.4%和42.9%.治疗组不良反应以腹泻最常见(20.0%),有5例在治疗初期因腹泻加重而中途退出.其次为恶心、上腹不适、皮疹等.对照组以白细胞减少多见(33.3%),其次为恶心、皮疹、上腹不适等.结论奥沙拉秦钠胶囊治疗UC是一种安全有效的药物.     

复方谷氨酰胺肠溶胶囊联合布拉氏酵母菌治疗腹泻型肠易激综合征临床效果观察

[目的]观察复方谷氨酰胺肠溶胶囊联合布拉氏酵母菌治疗腹泻型肠易激综合征(IBS-D)的临床效果.[方法]120例IBSD患者,随机分为观察组60例,予复方谷氨酰胺肠溶胶囊联合布拉氏酵母菌治疗;对照组60例,予复方谷氨酰胺肠溶胶囊治疗,2组均以4周为一疗程.[结果]观察组总有效率90.0％,对照组总有效率63.3％,观察组疗效高于对照组(P＜0.05);2组均未见明显不良反应.[结论]复方谷氨酰胺肠溶胶囊联合布拉氏酵母菌治疗IBS-D的临床疗效优于复方谷氨酰胺肠溶胶囊.     

复方谷氨酰胺肠溶胶囊对腹泻为主型肠易激综合征的临床疗效观察

肠易激综合征（IBS）是一种常见的慢性肠功能紊乱性疾病，目前治疗方法较多，但疗效均不确切。目的：观察复方芥氨酰胺肠溶胶囊对腹泻为主型IBS的临床疗效。方法：80例腹泻为主型IBS患者随机分为2组。每组40例，分别予复厅符氨酰胺肠溶胶囊（500mg，3次／天）和枯草杆菌、肠球菌二联活菌肠溶胶囊（500mg，3次／天），疗程2周。治疗7天和14天后询问并记录腹泻、腹痛和腹胀等症状的改善情况。结果：复方谷氨酰胺肠溶胶囊组的总有效率为85．0％，二联活菌肠溶胶囊组为72．5％，差异无统计学意义；复方谷氨酰胺肠溶胶囊治疗腹泻的疗效优于二联活菌肠溶胶囊（92．5％对60．0％，P〈0．05），两组对腹痛、腹胀的疗效无统计学差异．结论：复方谷氨酰胺肠溶胶囊和二联活菌肠溶胶囊均对腹泻为主型IBS有效，但前者治疗腹泻的疗效优于后者。     

复方苦参结肠溶胶囊对溃疡性结肠炎患者的治疗作用及其机制

目的: 观察复方苦参结肠溶胶囊对溃疡性结肠炎(UC)患者的治疗作用以及对结肠黏膜IκB-α蛋白的表达作用, 并探讨其作用机制.方法: 经结肠镜及病理证实的UC患者24例,随机分为复方苦参组和美沙拉嗪组, 复方苦参组16例用复方苦参结肠溶治疗, 美沙拉嗪组8例用美沙拉嗪治疗, 共治疗8 wk. 采用免疫组织化学法检测患者治疗前后IκB-α蛋白的阳性细胞表达率.结果: 复方苦参组总有效率为93.75%, 美沙拉嗪组为87.50%, 2组差异无统计学意义(P >0.05). 复方苦参组和美沙拉嗪组治疗前结肠黏膜IκB-α蛋白阳性细胞表达率明显高于治疗后(25.6%±2.9% vs 21.5%±4.9%, 23.5%±5.6% vs 21.8%±5.0%, 均P <0.01), 治疗后复方苦参组结肠黏膜IκB-α蛋白阳性细胞表达率与美沙拉嗪组无明显统计学意义(P >0.05).结论: 复方苦参结肠溶胶囊对UC患者具有较好的治疗作用, 治疗后患者结肠黏膜IκB-α蛋白阳性细胞表达率明显降低, 这可能是其作用机制之一.     

双歧杆菌三联活菌胶囊、复方谷氨酰胺肠溶胶囊联合美沙拉嗪对溃疡性结肠炎的疗效观察

[目的]观察双歧杆菌三联活菌胶囊、复方谷氨酰胺肠溶胶囊联合美沙拉嗪对溃疡性结肠炎的疗效,为溃疡性结肠炎临床治疗提供帮助。[方法]入选100例溃疡性结肠炎患者,按随机数字表法分为对照组和治疗组,各50例,对照组患者采用美沙拉嗪治疗,治疗组患者采用双歧杆菌三联活菌胶囊、复方谷氨酰胺肠溶胶囊联合美沙拉嗪治疗,检测2组患者治疗前后总体症状评分、氧化应激指标(GSH-Px、CAT、SOD)、细胞因子(IL-2、TNF-α、IL-6、hs-CRP)及血流动力学指标(WHV、PV、PCV、PAdT)情况。[结果]治疗前2组患者总体症状评分、氧化应激指标、细胞因子及血流动力学指标比较差异无统计学差异(P0.05)。与治疗前比较,2组患者治疗后IL-2和氧化应激指标均显著升高,总体症状评分、血流动力学指标、MDA以及细胞因子显著降低,差异有统计学意义(P0.05)。治疗后,治疗组患者IL-2和氧化应激指标显著高于对照组,总体症状评分、血流动力学指标、MDA以及细胞因子显著低于对照组,2组比较差异有统计学意义(P0.05)。[结论]双歧杆菌三联活菌胶囊、复方谷氨酰胺肠溶胶囊与美沙拉嗪的联合治疗能够改善溃疡性结肠炎患者临床症状及血液情况、降低炎症反应以及防止氧化应激反应的加剧,对溃疡性结肠炎患者的临床治疗具有重要的意义。     

不同剂量美常安对溃疡性结肠炎患者维持治疗的临床对比研究

目的比较小剂量和标准剂量美常安对溃疡性结肠炎(ulcerative colitis,UC)患者维持治疗的疗效及安全性。方法选取2012年6月-2013年12月于湖北省襄阳市中心医院就诊的UC缓解期患者98例,随机分为3组:美沙拉嗪组,口服美沙拉嗪缓释颗粒1.5 g/d;小剂量美常安组,口服美常安750 mg/d;标准剂量美常安组,口服美常安1 500 mg/d。所有患者随访6个月,观察并记录维持缓解时间、不良反应情况,所有患者复查肠镜并记录UC活动度积分和病理组织学积分。结果三组患者UC复发率、维持缓解时间、肠镜活动度积分及病理组织学积分差异均无统计学意义(P0.05)。结论小剂量美常安在UC患者维持治疗中是安全、有效的。     

奥沙拉嗪联合复方嗜酸乳杆菌片治疗溃疡性结肠炎的临床观察

[目的]观察奥沙拉嗪联合复方嗜酸乳杆菌片治疗溃疡性结肠炎(UC)的疗效。[方法]将经肠镜检查确诊的54例UC患者随机分为2组,治疗组27例,口服奥沙拉嗪胶囊1.0g,3次/d,复方嗜酸乳杆菌片1.0g,3次/d;对照组27例,口服奥沙拉嗪胶囊1.0g,3次/d。2组疗程均为8周。治疗前后观察临床症状积分改善情况,疗程结束1周后,复查肠镜评估溃疡愈合情况,治疗期间记录2、4、6、8周末临床症状改善情况。[结果]治疗组临床症状积分,有效率,2、4、6、8周末临床症状改善情况均优于对照组,2组比较差异有统计学意义(P0.05)。[结论]奥沙拉嗪联合复方嗜酸乳杆菌片治疗UC临床症状改善快,有效率高,值得推广使用。     

美常安联合美沙拉嗪在UC患者中的应用效果及其对患者SOD、MDA、白细胞介素和TNF-α的影响

目的观察枯草杆菌二联活菌肠溶胶囊联合美沙拉嗪治疗溃疡性结肠炎的疗效及对血清相关因子的影响.方法选取湖州市安吉县人民医院消化内科在2014-08/2016-11收治的溃疡性结肠炎患者86例,按照随机数字表法分为观察组和对照组,各43例,对照组患者给予美沙拉嗪肠溶片口服治疗;观察组在对照组基础上联用枯草杆菌二联活菌肠溶胶囊口服治疗;连续治疗2 mo.观察两组患者临床疗效、症状缓解时间、Rachmitewitz评分、Sutherland评分;检测血清白介素-6(interleukin 6,IL-6)、IL-8、IL-10、肿瘤坏死因子-α(tumor necrosis factorα,TNF-α)炎症因子水平和丙二醛(malondialdehyde,MDA)、超氧化物歧化酶(superoxide dismutase,SOD)、环氧合酶-2(cyclooxygenase-2,COX-2)、核因子-κB(nuclear factor-κB,NF-κB)水平,随访6 mo,记录两组患者复发情况.结果观察组临床总有效率高于对照组(93.02%v s76.74%),差异具有统计学意义(Z=4.440,P=0.035);观察组腹泻缓解时间、腹痛缓解时间、黏液脓血便缓解时间短于对照组,差异显著(P0.05);治疗后两组患者Rachmitewitz、Sutherland评分与治疗前比较明显下降,观察组评分低于对照组(P0.05);治疗后,观察组IL-6、IL-8、TNF-α水平低于对照组,IL-10水平高于对照组,差异显著(P0.05);治疗后观察组MDA、COX-2、NF-κB水平低于对照组,SOD水平高于对照组,差异显著(P0.05);随访6 mo,观察组复发率为11.63%,对照组复发率为16.28%,比较无统计学差异.结论枯草杆菌二联活菌肠溶胶囊与美沙拉嗪联合治疗溃疡性结肠炎效果优于单一采用美沙拉嗪治疗,能够促进患者临床症状缓解,降低血清炎症因子水平,改善机体氧化应激状态,但对远期复发无明显影响.     

自拟愈溃方维持缓解脾肾阳虚型溃疡性结肠炎的临床疗效观察

[目的]观察自拟愈溃方加减维持缓解脾肾阳虚型溃疡性结肠炎(UC)的临床疗效。[方法]41例脾肾阳虚型UC患者随机分为2组,治疗组20例,给予自拟愈溃方加减中药汤剂;对照组21例,给予美沙拉秦缓释颗粒剂口服,1.5g/d。2组均随访治疗1年。观察2组患者维持缓解,依从性及不良反应发生情况。[结果]试验结束时,治疗组和对照组分别有15和10例处于维持缓解期,Kaplan-Meier生存曲线显示治疗组在UC维持缓解方面略优于对照组,但差异无统计学意义。2组患者均无不良反应发生。依从性方面,治疗组脱落2例,对照组脱落6例,差异无统计学意义。[结论]自拟愈溃方可有效且安全地维持缓解脾肾阳虚型UC。     

奥沙拉嗪与SASP灌肠治疗溃疡性结肠炎的疗效对比观察

目的观察用奥沙拉嗪灌肠方法治疗活动期溃疡性结肠炎的治疗效果，比较奥沙拉嗪与水扬酸偶氮磺胺吡啶（SASP）用灌肠方法治疗活动期溃疡性结肠炎的疗效和不良反应。方法采用随机双盲双模拟方法观察40例活动期溃疡性结肠炎的疗效和不良反应，疗程为4周。结果治疗4周末奥沙拉嗪组的总体疗效评价其显效率为70％，临床症状、体征消失率、内镜完全缓解率和组织学完全缓解率分别为60％、45％、75％及60％，对照组总体疗效评价其显效率为50％，临床症状、体征消失率、内镜完全缓解率和组织学完全缓解率分别为50％、30％、55％及50％，其疗效与对照组相比有明显差异（P〈0．05）。结论用奥沙拉嗪灌肠方法治疗活动期溃疡性结肠炎有较好的疗效，其疗效优于SASP组，且奥沙拉嗪的主要不良反应腹泻明显减少。     

Prophylactic effects of olsalazine v sulphasalazine during 12 months maintenance treatment of ulcerative colitis. The Danish Olsalazine Study Group.

In a Danish multicentre trial we compared the relapse preventing effects of olsalazine and sulphasalazine in patients with ulcerative colitis over a 12 month treatment period. Two hundred and twenty seven patients (118 men) with at least two previous attacks of ulcerative colitis were randomly allocated according to a prearranged treatment schedule to olsalazine 500 mg bd or sulphasalazine 1 g bd in a double blind, double dummy fashion. One hundred and ninety seven patients completed the trial. The relapse rate after 12 month in the olsalazine group was 46.9% v 42.4% in the sulphasalazine group with a 95% confidence interval for the difference in proportions of -9% to 18%. Seven per cent of the patients were withdrawn from the trial because of adverse drug reactions and these were equally distributed between the two groups.     

奥沙拉嗪联合地塞米松保留灌肠治疗溃疡性结肠炎的疗效评价

[目的]评价奥沙拉嗪联合地塞米松保留灌肠治疗溃疡性结肠炎(ulcerative colitis,UC)的疗效及安全性.[方法]50例UC患者随机分为观察组(26例,采用奥沙拉嗪联合地塞米松保留灌肠)、对照组(24例,采用柳氮磺嘧啶联合地塞米松保留灌肠),比较2组治疗前及治疗1个月、2个月后患者疾病活动指数(disease activity index,DAI),治疗2个月后总有效率及不良反应发生情况.[结果]2组患者治疗前DAI差异无统计学意义(P＞0.05);治疗1个月后,2组患者DAI均较治疗前降低(P＜0.05),而2组间比较差异无统计学意义(P＞0.05);治疗2个月后,2组DAI均较治疗前下降显著(P＜0.01),观察组优于对照组,差异有统计学意义(P＜0.05).治疗2个月后,观察组总有效率为92.3％,对照组为75.0％,2组比较差异有统计学意义(P＜0.05).[结论]奥沙拉嗪联合地塞米松保留灌肠治疗UC患者安全有效,值得临床推广.     

Olsalazine sodium in the treatment of ulcerative colitis among patients intolerant of sulfasalazine. A prospective, randomized, placebo-controlled, double-blind, dose-ranging clinical trial

Sixty-six outpatients with active ulcerative colitis who were intolerant of sulfasalazine were treated in a double-blind randomized trial. They received placebo or olsalazine sodium in daily doses of 0.75, 1.5, or 3 g. Overall, 35% of patients receiving olsalazine improved clinically, compared to 16% of patients receiving placebo. When the colitis activity at study entry was compared with that observed at the completion of the study period, statistically significant or nearly significant improvement was demonstrated within the combined olsalazine group (p = 0.01) and within patient groups receiving olsalazine at daily doses of 1.5 g (p = 0.04) and 3 g (p = 0.055). A dose-response relationship was suggested because 16%, 29%, 27%, and 50% of patients improved in the placebo and 0.75-, 1.5-, and 3-g olsalazine groups, respectively, (p = 0.04). A similar pattern of improvement was seen when sigmoidoscopic criteria were used, although a dose-response relationship was not demonstrated. There were no differences between the treatment and placebo groups for any of the adverse effects or laboratory variables reported at baseline or during the trial period. Four patients were withdrawn because of adverse reactions: 2 developed a skin rash while receiving olsalazine and 2 had diarrhea, one while on olsalazine and the other while on placebo. The data suggest that olsalazine is effective for the treatment of ulcerative colitis and is well tolerated among patients intolerant to sulfasalazine.     

Olsalazine is not superior to placebo in maintaining remission of inactive Crohn's colitis and ileocolitis: a double blind, parallel, randomised, multicentre study

BACKGROUND AND AIMS: The benefit of 5-aminosalicylic acid therapy for maintenance of remission in Crohn's disease is controversial. The primary aim of this study was to evaluate the prophylactic properties of olsalazine in comparison with placebo for maintenance of remission in quiescent Crohn's colitis and/or ileocolitis. METHODS: In this randomised, double blind, parallel group study of olsalazine versus placebo, 328 patients with quiescent Crohn's colitis and/or ileocolitis were recruited. Treatment consisted of olsalazine 2.0 g daily or placebo for 52 weeks. The primary end point of efficacy was relapse, as defined by the Crohn's disease activity index (CDAI) and by clinical relapse. Laboratory and clinical disease activity indicators were also measured. Safety analysis consisted of documentation of adverse events and laboratory values. RESULTS: No differences in the frequency of termination due to relapse or time to termination due to relapse were noted between the two treatment groups (olsalazine 48.5% v placebo 45%) for either colitis or ileocolitis. The failure rate, defined as not completing the study, was significantly higher in olsalazine treated patients compared with placebo treated patients for the overall population (colitis and/or ileocolitis: olsalazine 65.4% v 53.9%; p=0.038). Similar failure rates were seen for patients with colitis. A significantly higher percentage of olsalazine treated patients experienced adverse gastrointestinal events. Drug attributed adverse events were reported more frequently in the olsalazine treated group with gastrointestinal symptoms being causally related to olsalazine treatment (olsalazine 40.7% v placebo 26.9%; p=0.010). Back pain was reported significantly more often by the placebo treated group. However, serious medical events did not differ between the two groups. Adverse events led to more early withdrawals in the olsalazine treated group than in the placebo treated group; thus average time in the study for patients in the olsalazine treatment group was significantly shorter than that of patients in the placebo group. CONCLUSIONS: Patients treated with olsalazine were more likely to terminate their participation in the trial than those taking placebo. This difference was not related to relapse of disease, as measured by CDAI and clinical measures, but rather was due to the development of intolerable adverse medical events of a non-serious nature related to the gastrointestinal tract. The gastrointestinal related events in the olsalazine treated group may be due to the difference in gastrointestinal status at baseline which favoured the placebo treatment group.     

Olsalazine Versus Sulphasalazine for Relapse Prevention in Ulcerative Colitis: A Multicenter Study

Objective : To compare the relapse-preventing effect and the frequency of adverse events of olsalazine and sulphasalazine in sulphasalazine-tolerant patients with ulcerative colitis. Methods : Patients in remission, with at least two episodes of active disease during the last 5 yr, were randomized to 2 g of sulphasalazine or 1 g of olsalazine daily and were followed for 6–18 months. Relapse rates in the two groups were compared using frequency and life-table analysis. Sixty-nine patients with proctitis, 140 with left-sided colitis, and 113 with subtotal or total colitis were evaluated. Results : In the intention-to-treat analysis, the failure rate (relapses plus withdrawals) was 54.7% in the olsalazine and 47.2% in the sulphasalazine group. In the per-protocol analysis excluding withdrawals, 44.7% relapsed in the olsalazine and 39.3% in the sulphasalazine group. Remission curves did not differ significantly, although at all time intervals the frequency of remission was slightly higher in the sulphasalazine group ( p = 0.19 in the intention-to-treat analysis and p = 0.42 in the per-protocol analysis estimated by the log-rank test). Twelve patients (of whom five had diarrhea) in the olsalazine group versus eight patients in the sulphasalazine group discontinued the study because of side effects. Conclusion : The relapse-preventing effect of olsalazine and sulphasalazine in sulphasalazine-tolerant patients did not differ. Furthermore, the tolerability of olsalazine, particularly concerning diarrhea, appears to be better than previously reported.     

Controlled trial comparing olsalazine and sulphasalazine for the maintenance treatment of ulcerative colitis.

One hundred and sixty four patients with ulcerative colitis in remission were entered into a double blind, double dummy trial comparing olsalazine 500 mg bd and sulphasalazine 1 g bd. Clinical examination, sigmoidoscopy and rectal biopsy were performed at 0, three, and six months. Sixteen of 82 (19.5%) patients relapsed on olsalazine and 10/82 (12.2%) relapsed on sulphasalazine. The difference was not statistically significant (p = 0.1632). Adverse events were minor and were similar in both groups. No haematological or biochemical abnormalities were detected. Thus, olsalazine is as effective as sulphasalazine for preventing a relapse of ulcerative colitis.     

Olsalazine in maintenance of clinical remission in patients with ulcerative colitis

Frequent minor side effects are associated with sulfasalazine. The realization that it is the 5-aminosalicylic acid moiety that is the active component of sulfasalazine and that the side effects are probably due to the sulfapyridine has prompted the search for a similar but safer compound. Olsalazine, consisting of two molecules of 5-ASA without sulfasalazine may avoid the problems due to sulfasalazine. One hundred one patients were entered into a double-blind placebo-controlled study of the use of olsalazine 92 g daily) in preventing relapse in patients who had recently recovered from an acute attack of ulcerative colitis. Patients were treated for 12 months. Forty-nine were randomized to olsalazine (39 with limited and 10 with extensive disease) and 52 to placebo (42 with limited and 10 with extensive disease). Life-table analysis showed that the median time to relapse in patients on olsalazine was 342 days, which was significantly longer than the 100 days in the placebo group (P=0.024). The most important side effect experienced with olsalazine that necessitated withdrawal from the study was drug-induced diarrhea in 16% (8/49). There was a similar incidence of minor side effects reported in the two groups, and in no patients were major or dangerous side effects reported. In patients who did not develop diarrhea, olsalazine was well tolerated and successfully prevented rapid relapse in the recently ill patients entered into this study.     

A prospective randomized observer-blind 2-year trial of azathioprine monotherapy versus azathioprine and olsalazine for the maintenance of remission of steroid-dependent ulcerative colitis

OBJECTIVE: The aim of this prospective study was to assess whether the coadministration of azathioprine (AZA) and olsalazine is superior to AZA monotherapy in maintaining remission of steroid-dependent ulcerative colitis (UC). METHODS: Patients with steroid-dependent UC in remission were randomized to receive AZA alone (2.2 mg/kg) or in combination with olsalazine (0.5 g tid). Remission was defined as steroid withdrawal, an Ulcerative Colitis Clinical Activity Index (UCCAI) score of <2, an Ulcerative Colitis Disease Activity Index (UCDAI) score of 0, and a negative colonoscopy and histology. Patients were followed in the outpatient clinic every month for 2 yr. The study protocol included 1) monthly clinical examination, assessment of UCCAI, hematological and biochemical tests, and compliance with treatment; 2) a sigmoidoscopy and completion of inflammatory bowel disease quality-of-life questionnaire (IBD-Q) and UCDAI every 3 months; and 3) total colonoscopy with biopsies at the end of the first and second year of the trial. RESULTS: Seventy patients were randomized to receive AZA alone (n = 34) or with olsalazine (n = 36). Three patients in each group developed side effects or could not comply with treatment and were withdrawn from the study. Three patients receiving AZA relapsed after the first year of the study and three after the second year of the study (19%). In the combination therapy group four patients relapsed after the first year of study and two after the second year of the study (18%). Relapse rates were not significant whether analyzed by intention-to-treat or per protocol. There were no significant differences between groups in time to relapse or discontinuation of treatment, UCCAI, UCDAI, or IBD-Q scores. However, the number of adverse events and the cost of treatment were significantly higher, whereas compliance with treatment was poorer in the combination therapy. CONCLUSION: Patients with steroid-dependent UC successfully maintained in remission on AZA are not in need of 5-aminosalicylic acid compounds.