Atay A, Ergul M, Ozturk O, Acun KC, Cagir Y, Durak MB, Yuksel I. Outcomes of 5-aminosalicylates withdrawal due to non-adherence in ulcerative colitis patients: A step toward evaluating intermittent therapy. World J Gastroenterol 2025; 31(30): 110112 [PMID: 40904881 DOI: 10.3748/wjg.v31.i30.110112]
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08549003
Submitted on:
August 09, 2025, 02:20
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Reader Comments:
Inflammatory bowel disease is a chronic, debilitating, lifelong disease with waxing and waning. Since the disease is chronic, long-term medical therapy is required. Often, a few patients may not be adherent to medications due to various reasons, and this study explored this aspect with the expansion of Withdrawal of drugs in IBD. Most of the patients who were not adherent may present with acute severe ulcerative colitis, and most of them will have recapture of the remission with steroids or original drugs. This Study also showed a similar picture, with only 1/4 requiring corticosteroids. This study is well-written, but in the era of treat-to-target, it notably overlooks the histological findings in patients with ASA withdrawal. Addition of Endoscopic and histopathological findings after withdrawal, even without relapse, would have given a better picture
Reply from the Editorial Office:
Thank you very much for your comments.
Author's Reply:
Replied on August 09, 2025, 21:58
We thank the reader for their insightful comments. We agree that endoscopic and histopathological assessments following 5-ASA withdrawal could provide valuable additional insights. However, the design of our study was focused on evaluating clinical outcomes and treatment patterns rather than histological or endoscopic parameters. Our aim was to present a clear, real-world picture of the clinical course after 5-ASA withdrawal in ulcerative colitis patients in remission. We appreciate this perspective, and future studies incorporating histological and endoscopic follow-up may further enhance understanding of this clinical scenario.