Response: Comments on “Role of 5-aminosalicylic acid in ulcerative colitis management in 8 Asian territories: a physician survey”
Article information
We sincerely thank Nishida et al. [1] for their insightful responses to our article “Role of 5-aminosalicylic acid in ulcerative colitis management in 8 Asian territories: a physician survey [2].” We appreciate their efforts to enrich regional understanding by sharing data from Japan, which was not included in our study. As they noted, the prioritization of long-term remission and mucosal healing in Japan, supported by robust public healthcare subsidies, highlights the critical difference that healthcare infrastructure and reimbursement systems could have on treatment goals. Our survey observed that affordability is a pivotal factor in decision-making in many Asian territories, whereas the Japanese experience underscores how reduced cost barriers may promote a more proactive, guideline-driven approach to disease management.
The comparison regarding dosing frequency is especially constructive. We concur that once-daily dosing improves adherence and is positively received where access to appropriate formulations exists. Economic and logistical constraints in other Asian territories may limit the real-world application of simplified regimens, but these differences invite future collaboration to improve access and optimize therapy. We are also grateful for their opinion on the monitoring strategies and for highlighting the observed differences between the 2 surveys. Notably, both studies identified endoscopy as an essential modality for disease monitoring. Furthermore, our results indicated that C-reactive protein and histologic activity did not significantly influence physicians’ decisions to modify treatment regimens. These findings aligned with the Japanese survey, where only 29%, 10%, and 17% of physicians considered serum inflammatory markers, fecal inflammatory markers, and histologic activity, when contemplating de-escalation of 5-ASA (5-aminosalicylic acid; also known as mesalamine) therapy.
Finally, Prof. Nishid’s study [1] provides comprehensive insights into the patterns of mesalamine de-escalation and elucidates the factors influencing decisions to reduce or discontinue medication. These findings constitute a valuable resource and are expected to inform future guideline recommendations regarding mesalamine exit strategies. We value the comparative insights provided and agree that expanding regional collaboration in sharing experiences, as exemplified here, are vital for optimizing ulcerative colitis management in Asia.
Notes
Funding Source
The authors received no financial support for the research, authorship, and/or publication of this article.
Conflict of Interest
No potential conflict of interest relevant to this article was reported.
Data Availability Statement
Data sharing is not applicable as no new data were created or analyzed in this study.
Author Contributions
Writing - original draft: Limsrivilai J. Writing - review & editing: Leung WK. Approval of final manuscript: all authors.