Prevention

Give 5-aminosalicylates (preferably sulfasalazine) ^a as tablets and enemas. ^a  

Why?

• 5-aminosalicylates reduce relapse ^a
• Sulfasalazine is more effective than newer compounds. ^a
• The combination of enemas and tablets prevents more relapses than tablets alone. ^a

Ulcerative colitis: 5-aminosalicylates reduces relapse

Patient	Treatment	Comparison	Outcome	CER	OR (95% CI)	NNT (95% CI)
ulcerative colitis in remission a	5-ASA	placebo	relapse at 6-12 months	65%	0.48 (0.37 to 0.62)	6 (4 to 9)
	newer 5-ASAs	sulfasalazine	relapse at 6-12 months	44%	1.29 (1.05 to 1.57)	-16 (-83 to -9)

Ulcerative colitis: combining 5-ASA tablets and enemas reduce relapses

Patient	Treatment	Comparison	Outcome	CER	RRR (95% CI)	NNT (95% CI)
ulcerative colitis in remission a	5-ASA enemas and tablets	5-ASA tablets	relapse at 12 months	65%	38% (-1% to 62%)	4 (2 to 62)