AUTHOR=Wu Zhendong , Ni Chuyan , Ye Zhen , Xia Zhongsheng , Li Li , Yu Zhong , Tang Song , Lin Ying , Zhong Wa 

TITLE=The efficacy of aminosalicylates in acute radiation enteritis: a systematic review and meta-analysis

JOURNAL=Frontiers in Pharmacology

VOLUME=Volume 16 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2025.1544981

DOI=10.3389/fphar.2025.1544981

ISSN=1663-9812

ABSTRACT=Background and purposeAminosalicylates have been used for the prevention and treatment of radiation enteritis (RE) for more than 50 years. However, their effectiveness in acute radiation enteritis (ARE) has been controversial. We conducted a meta-analysis to clarify the clinical efficacy of aminosalicylates in controlling the symptoms of ARE.Materials and methodsWe searched PubMed, Cochrane Library, Embase, and Web of Science for studies published before January 2020. Eligible randomized controlled trials (RCTs) comparing the incidence of diarrhea, abdominal pain, constipation, tenesmus, and hematochezia between the aminosalicylates and control groups were included. Subgroup analyses were conducted based on different drugs and doses. Publication bias was assessed using funnel plots.ResultsSeven RCTs with 613 patients were included. Aminosalicylates reduced the incidence of mild to moderate diarrhea (P < 0.05), while total diarrhea, severe diarrhea, abdominal pain, hematochezia, tenesmus, and constipation showed no significant differences from the control group. Subgroup analysis showed that sulfasalazine (SASP) reduced mild to moderate diarrhea (P < 0.05), whereas 5-aminosalicylic acid (5-ASA) increased total and severe diarrhea (P < 0.05). Additionally, when aminosalicylate doses exceeded 2 g/d, diarrhea incidence increased (P < 0.05).ConclusionSASP is a safe and effective treatment for mild to moderate diarrhea, while 5-ASA may increase diarrhea incidence in ARE patients. Aminosalicylates at ≤2 g/d are safe for ARE, but higher doses may worsen diarrhea.