{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T01:16:19Z","timestamp":1760577379416},"reference-count":14,"publisher":"Hindawi Limited","license":[{"start":{"date-parts":[[2016,1,1]],"date-time":"2016-01-01T00:00:00Z","timestamp":1451606400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Canadian Journal of Gastroenterology and Hepatology"],"published-print":{"date-parts":[[2016]]},"abstract":"<jats:p><jats:italic>Background.<\/jats:italic>Ulcerative proctitis (UP) is typically treated initially with oral 5-aminosalicylate (\u201c5-ASA\u201d), mesalamine suppository, or mesalamine enema (\u201cUP Rx\u201d). Little is known about their effectiveness in practice.<jats:italic>Methods.<\/jats:italic>Using a US health insurance database, we identified new-onset UP patients between January 1, 2005, and December 31, 2007, based on the following: (1) initiation of UP Rx; (2) endoscopy in prior 30 days resulting in diagnosis of UP; and (3) no prior encounters for ulcerative colitis or Crohn\u2019s disease. We examined the incidence of therapy escalation and total costs in relation to initial UP Rx.<jats:italic>Results.<\/jats:italic>We identified 548 patients: 327 received mesalamine suppository, 138 received oral 5-ASA, and 83 received mesalamine enema, as initial UP Rx. One-third receiving oral 5-ASA experienced therapy escalation over 12 months, 21% for both mesalamine suppository and enema. Mean cumulative total cost of UP Rx over 12 months was $1552, $996, and $986 for patients beginning therapy with oral 5-ASA, mesalamine enema, and mesalamine suppository, respectively. Contrary to expert recommendations the treatments were often not continued prophylactically.<jats:italic>Conclusions.<\/jats:italic>Treatment escalation was common, and total costs of therapy were higher, in patients who initiated treatment with oral 5-ASA. Further study is necessary to assess the significance of these observations.<\/jats:p>","DOI":"10.1155\/2016\/6928710","type":"journal-article","created":{"date-parts":[[2016,4,12]],"date-time":"2016-04-12T21:01:08Z","timestamp":1460494868000},"page":"1-7","source":"Crossref","is-referenced-by-count":4,"title":["Oral 5-Aminosalicylate, Mesalamine Suppository, and Mesalamine Enema as Initial Therapy for Ulcerative Proctitis in Clinical Practice with Quality of Care Implications"],"prefix":"10.1155","volume":"2016","author":[{"given":"James M.","family":"Richter","sequence":"first","affiliation":[{"name":"Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nabeela K.","family":"Arshi","sequence":"additional","affiliation":[{"name":"Policy Analysis Inc., Brookline, MA 02445, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerry","family":"Oster","sequence":"additional","affiliation":[{"name":"Policy Analysis Inc., Brookline, MA 02445, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"98","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1016\/j.crohns.2010.12.011"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1016\/s0002-9270(99)00829-1"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2009.727"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1097\/00001574-200407000-00008"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1097\/01.mib.0000231496.92013.85"},{"issue":"5","key":"6","first-page":"893","volume":"3","year":"2007","journal-title":"Therapeutics and Clinical Risk Management"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1007\/bf02236902"},{"issue":"7","key":"8","first-page":"1338","volume":"91","year":"1996","journal-title":"American Journal of Gastroenterology"},{"issue":"4","key":"9","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1016\/0016-5085(88)90569-0","volume":"94","year":"1988","journal-title":"Gastroenterology"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9270(00)00732-2"},{"key":"13","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2011.04619.x"},{"key":"16","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2015.03.001"},{"issue":"10","key":"14","first-page":"1867","volume":"92","year":"1997","journal-title":"American Journal of Gastroenterology"},{"key":"15","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-009-1074-z"}],"container-title":["Canadian Journal of Gastroenterology and Hepatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/cjgh\/2016\/6928710.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/cjgh\/2016\/6928710.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/cjgh\/2016\/6928710.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2017,6,24]],"date-time":"2017-06-24T10:46:54Z","timestamp":1498301214000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.hindawi.com\/journals\/cjgh\/2016\/6928710\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016]]},"references-count":14,"alternative-id":["6928710","6928710"],"URL":"https:\/\/doi.org\/10.1155\/2016\/6928710","relation":{},"ISSN":["2291-2789","2291-2797"],"issn-type":[{"value":"2291-2789","type":"print"},{"value":"2291-2797","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016]]}}}