Primary diverticulitis with abscess formation and young age increased the risk of recurrence .
Readmission risk was higher within the first year after remission .
Conclusions The best treatment strategy for recurrent diverticulitis is undetermined .
Purpose Several factors may influence the risk of recurrence after an episode of acute colonic diverticulitis .
Until now , a comprehensive systematic overview and evaluation of relevant risk factors have not been presented .
This review aim ed at assembling and evaluating current evidence on risk factors for recurrence after conservatively treated acute colonic diverticulitis .
Mesalamine did not prevent recurrent diverticulitis in phase 3 controlled trials.
BACKGROUND & AIMS No therapy has been proven to prevent the recurrence of diverticulitis . Mesalamine has shown efficacy in preventing relapse in inflammatory bowel disease , and there is preliminary evidence that it might be effective for diverticular disease . We investigated the efficacy of mesalamine in preventing recurrence of diverticulitis in 2 identical but separate phase 3 , r and omized , double-blind , placebo-controlled , multicenter trials ( identical confirmatory trials were conducted for regulatory reasons ) . METHODS We evaluated the efficacy and safety of multimatrix mesalamine vs placebo in the prevention of recurrent diverticulitis in 590 ( PREVENT1 ) and 592 ( PREVENT2 ) adult patients with ≥1 episodes of acute diverticulitis in the previous 24 months that resolved without surgery . Patients received mesalamine ( 1.2 g , 2.4 g , or 4.8 g ) or placebo once daily for 104 weeks . The primary end point was the proportion of recurrence-free patients at week 104 . Diverticulitis recurrence was defined as surgical intervention at any time for diverticular disease or presence of computed tomography scan results demonstrating bowel wall thickening ( > 5 mm ) and /or fat str and ing consistent with diverticulitis . For a portion of the study , recurrence also required the presence of abdominal pain and an increase in white blood cells . RESULTS Mesalamine did not reduce the rate of diverticulitis recurrence at week 104 . Among patients in PREVENT1 , 53%-63 % did not have disease recurrence , compared with 65 % of those given placebo . Among patients in PREVENT2 , 59%-69 % of patients did not have disease recurrence , compared with 68 % of those given placebo . Mesalamine did not reduce time to recurrence , and the proportions of patients requiring surgery were comparable among treatment groups . No new adverse events were identified with mesalamine administration . CONCLUSIONS Mesalamine was not superior to placebo in preventing recurrent diverticulitis . Mesalamine is not recommended for this indication . Clinical Trials.gov ID : NCT00545740 and NCT00545103
Primary diverticulitis with abscess formation and young age increased the risk of recurrence .
Readmission risk was higher within the first year after remission .
Conclusions The best treatment strategy for recurrent diverticulitis is undetermined .
Purpose Several factors may influence the risk of recurrence after an episode of acute colonic diverticulitis .
Until now , a comprehensive systematic overview and evaluation of relevant risk factors have not been presented .
This review aim ed at assembling and evaluating current evidence on risk factors for recurrence after conservatively treated acute colonic diverticulitis .