OBJECTIVES: The development of new technologies for ulcerative colitis (UC) treatment such as multi-matrix form of 5-aminosalicylic acid (MMX5-ASA) has already shown efficacy over placebo, but not over the coated tablet form (CT5-ASA), the most used in clinical protocols. This study aimed at carrying out a systematic review to gather evidence that can reveal pre-eminence or equivalence in efficacy of these pharmaceutical forms in remission induction of UC.

METHODS: Two independent researchers using Pubmed, Embase, Web of Science, Clinical Trials, Scopus and Science Direct databases and manual search selected eligible randomized clinical trials according to some pre-established inclusion criteria. This research was carried out without limitation of time interval or language, using clinical and endoscopic remission rates as primary endpoints of analysis.

RESULTS: The study included 1,108 individuals who were analyzed and separated in two groups (MMX5-ASA and CT5-ASA). Regarding endoscopic remission, only two papers compared mucosal appearance and intestinal scarring before and after the treatments of two and six months (2.4g and 1.6g of MMX5-ASA/day, respectively). Both trials have demonstrated that similar levels of endoscopic remission were achieved in both forms of the drug, so that more than half of population in each group achieved an improvement in intestinal mucosa aspect. According to the clinical remission, only another two papers used a modified UC-DAI score (which includes increase of stool frequency, rectal bleeding and endoscopy data) for analysis. While one study showed that better results are achieved with the use of MMX technology compared to coated tablets (41.7% vs. 33.7%, respectively). The other one registered that there are no statically differences between both groups (68% vs. 66%, respectively; p=0.69).

CONCLUSIONS: This study evidences that there are few clinical studies to demonstrate the superiority of MMX5-ASA when compared to CT5-ASA during ulcerative colitis treatment. Thus, more clinical studies are required.