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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Meta-Anal. Dec 18, 2025; 13(4): 108681
Published online Dec 18, 2025. doi: 10.13105/wjma.v13.i4.108681
Published online Dec 18, 2025. doi: 10.13105/wjma.v13.i4.108681
Reevaluating aminosalicylates role in maintaining remission in ulcerative colitis: Systematic review and meta-analysis in the era of biologics
Themba Mudege, Jonathan Soldera, Department of Gastroenterology, University of South Wales, Cardiff CF37 1DL, United Kingdom
Co-first authors: Themba Mudege and Jonathan Soldera.
Author contributions: Soldera J and Mudege T participated in the concept and design research, drafted the manuscript and contributed to data acquisition, analysis and interpretation; Soldera J contributed to study supervision; all authors contributed to critical revision of the manuscript for important intellectual content.
Conflict-of-interest statement: All authors declare no conflicts of interest related to this study.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jonathan Soldera, PhD, Tutor, Department of Gastroenterology, University of South Wales, Llantwit Road, Pontypridd, Cardiff, CF37 1DL, United Kingdom.
Received: April 21, 2025
Revised: June 9, 2025
Accepted: December 10, 2025
Published online: December 18, 2025
Processing time: 242 Days and 2.3 Hours
Revised: June 9, 2025
Accepted: December 10, 2025
Published online: December 18, 2025
Processing time: 242 Days and 2.3 Hours
Core Tip
Core Tip: Oral 5-aminosalicylic acid (5-ASA) has long been a cornerstone treatment for maintaining remission in ulcerative colitis (UC). This systematic review and meta-analysis of 44 randomized controlled trials, involving nearly 10000 patients, demonstrates that 5-ASA is significantly more effective than placebo in sustaining remission in quiescent UC, with a favorable safety profile. Despite the emergence of advanced therapies such as biologics and small molecules, 5-ASA remains a viable and cost-effective option. These findings underscore the enduring relevance of 5-ASA and highlight the need for tailored therapeutic approaches in the modern management of UC.