{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T03:58:28Z","timestamp":1768449508130,"version":"3.49.0"},"reference-count":18,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T00:00:00Z","timestamp":1765238400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T00:00:00Z","timestamp":1765238400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Inflamm Intest Dis"],"abstract":"<jats:p>Introduction: 5-Aminosalicylic acid (5-ASA, mesalamine) is the cornerstone for maintaining remission in mild-to-moderate ulcerative colitis (UC), with several formulations available. Nonadherence to mesalamine is associated with increased relapse risk; however, large-scale real-world data comparing adherence and relapse among different formulations remain limited. This study aimed to evaluate adherence and relapse risk among four 5-ASA formulations using a large Japanese healthcare database. Methods: Using a Japanese nationwide claims database, we retrospectively analyzed UC patients who were prescribed any of four oral 5-ASA formulations \u2013 time-dependent mesalamine, pH-dependent mesalamine, multi-matrix system (MMX) mesalamine, or salazosulfapyridine \u2013 between 2008 and 2022. Adherence was assessed using the proportion of days covered (PDC), and relapse was defined as UC-related hospitalization or escalation of therapy. A Cox proportional hazards model was used to identify factors associated with relapse. Results: Among 13,876 eligible patients, MMX mesalamine showed the highest adherence (mean PDC: 91.6%) and the lowest relapse rate (2.9%), while salazosulfapyridine had the highest relapse rate (14.8%). In multivariate analysis, pH-dependent mesalamine (hazard ratio [HR], 0.60; 95% confidence interval [CI], 0.51\u20130.72) and MMX mesalamine (HR, 0.53; 95% CI, 0.35\u20130.78) significantly reduced relapse risk compared to time-dependent mesalamine, whereas salazosulfapyridine (HR, 1.51; 95% CI, 1.32\u20131.73) significantly increased relapse risk. Conclusion: MMX mesalamine was associated with the highest adherence and lowest relapse rates among the four 5-ASA formulations. These findings emphasize the importance of formulation choice in UC management.<\/jats:p>","DOI":"10.1159\/000549951","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T09:14:50Z","timestamp":1765358090000},"page":"43-52","source":"Crossref","is-referenced-by-count":0,"title":["Real-World Adherence and Relapse Risk in Mesalamine Treatment for Ulcerative Colitis: Insights from a Large Japanese Medical Claims Database"],"prefix":"10.1159","volume":"11","author":[{"given":"Takafumi","family":"Wada","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8808-5672","authenticated-orcid":false,"given":"Shuhei","family":"Hosomi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yumie","family":"Kobayashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rieko","family":"Nakata","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Nishida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirotsugu","family":"Maruyama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaki","family":"Ominami","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuji","family":"Nadatani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shusei","family":"Fukunaga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9075-6415","authenticated-orcid":false,"given":"Koji","family":"Otani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9186-1249","authenticated-orcid":false,"given":"Fumio","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuhiro","family":"Fujiwara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2025,12,9]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD000544.pub5"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2008.03865.x"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/s0002-9343(02)01383-9"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12396"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1186\/1471-230X-12-132"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.13715"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.12.036"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.2147\/PPA.S127039"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2009.04.004"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2009.12.054"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2018.12.008"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e31829b1d2a"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1176\/ps.2007.58.6.855"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-011-1843-3"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1097\/MIB.0b013e318280b1b8"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2024.04.012"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-012-0721-x"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8122109"}],"container-title":["Inflammatory Intestinal Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000549951","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T17:00:38Z","timestamp":1768410038000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000549951"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,9]]},"references-count":18,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000549951","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.30818342","asserted-by":"subject"}]},"ISSN":["2296-9403","2296-9365"],"issn-type":[{"value":"2296-9403","type":"print"},{"value":"2296-9365","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,9]]}}}