Balsalazide is superior to mesalamine in the time to improvement of signs and symptoms of acute mild-to-moderate ulcerative colitis

Pruitt, Ronald E.; Hanson, John S.; Safdi, Michael; Wruble, Lawrence D.; Hardi, Robert; Johanson, John F.; Koval, George; Riff, Dennis; Winston, Barry; Cross, Amanda J.; Doty, Pamela; Johnson, Lorin K.

doi:10.1016/s0002-9270(02)05520-x

Cited by 9 publications

(10 citation statements)

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“…As this was a phase II, dose-ranging, pilot study, it is difficult to compare our remission rates with those of previously reported studies. This is compounded by the fact that various definitions of remission have been employed in clinical trials of 5-ASAs for UC, 14,15 which are not directly comparable with those used in our study. Specifically, number and frequency of dosing of 5-ASA tablets, differences in endoscopic scoring systems and differences in study populations (e.g.…”

Section: Discussionmentioning

confidence: 69%

Once daily MMX mesalazine for the treatment of mild‐to‐moderate ulcerative colitis: a phase II, dose‐ranging study

D’Haens

Hommes

Engels

et al. 2006

Aliment Pharmacol Ther

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Section: Discussionmentioning

confidence: 69%

Once daily MMX mesalazine for the treatment of mild‐to‐moderate ulcerative colitis: a phase II, dose‐ranging study

D’Haens

Hommes

Engels

et al. 2006

Aliment Pharmacol Ther

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“…Oral therapy with the aminosalicylates (sulfasalazine, olsalazine, mesalamine, or balsalazide) is beneficial in achieving and maintaining remission ( 1,80 -84 ). Eff ective doses of sulfasalazine range between 4 and 6 g a day in four divided doses ( 85,86 ); for mesalamine 2 and 4.8 g per day in three divided doses ( 54,87 ); for balsalazide 6.75 g per day in three divided doses ( 82,88,89 ); and for olsalazine 1.5 -3 g per day in two divided doses ( 90 -93 ), although effi cacy of olsalazine in active UC is not conclusively established, perhaps in part because of a confounding dose-related diarrhea. A newer mesalamine formulated with a multimatrix formulation allows comparable effi cacy with once daily dosing in doses of 2.4 -4.8 g per day ( 94,95 ).…”

Section: In a Patient Presenting With Persistent Bloody Diarrhea Recmentioning

confidence: 99%

“…Th e " newer " aminosalicylates -balsalazide ( 82,88,89 ), olsalazine ( 90 -93 ), Eudragit-S-coated, pH-dependent mesalamine ( 54,87 ), ethylcellulose-coated mesalamine ( 131 ), and multimatrix-release mesalamine ( 83,132 ) -are all superior to placebo and equivalent to sulfasalazine in acute therapy ( 80 ). As with sulfasalazine, therapeutic benefi t requires a threshold dose, with daily doses less than 2 g being ineff ective ( 54,80,87,133 ).…”

Section: Recommendations For Maintenance Of Remission In Distal Diseasementioning

confidence: 99%

Ulcerative Colitis Practice Guidelines in Adults: American College of Gastroenterology, Practice Parameters Committee

Kornbluth

Sachar

2010

American Journal of Gastroenterology

1,144

977

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Guidelines for clinical practice are aimed to indicate preferred approaches to medical problems as established by scientifi cally valid research. Double-blind placebo controlled studies are preferable, but compassionate-use reports and expert review articles are used in a thorough review of the literature conducted through Medline with the National Library of Medicine. When only data that will not withstand objective scrutiny are available, a recommendation is identifi ed as a consensus of experts. Guidelines are applicable to all physicians who address the subject regardless of specialty training or interests and are aimed to indicate the preferable but not necessarily the only acceptable approach to a specifi c problem. Guidelines are intended to be fl exible and must be distinguished from standards of care, which are infl exible and rarely violated. Given the wide range of specifi cs in any healthcare problem, the physician must always choose the course best suited to the individual patient and the variables in existence at the moment of decision. Guidelines are developed under the auspices of the American College of Gastroenterology and its Practice Parameters Committee and approved by the board of trustees. Each has been intensely reviewed and revised by the Committee, other experts in the fi eld, physicians who will use them, and specialists in the science of decision analysis. The recommendations of each guideline are therefore considered valid at the time of composition based on the data available. New developments in medical research and practice pertinent to each guideline will be reviewed at a time established and indicated at publication to assure continued validity. The recommendations made are based on the level of evidence found. Grade A recommendations imply that there is consistent level 1 evidence (randomized controlled trials), grade B indicates that the evidence would be level 2 or 3, which are cohort studies or case -control studies. Grade C recommendations are based on level 4 studies, meaning case series or poor-quality cohort studies, and grade D recommendations are based on level 5 evidence, meaning expert opinion.

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“…The administration of balsalazine effectively induces remission in patients with mild to moderate UC. However, whether balsalazine improves intestinal mucosal permeability is still unknown [15,16] . [17,18] .…”

Section: Introductionmentioning

confidence: 99%

Balsalazine decreases intestinal mucosal permeability of dextran sulfate sodium-induced colitis in mice

Liu

Qiao

et al. 2009

Acta Pharmacol Sin

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Aim:To investigate the effect of balsalazine treatment on intestinal mucosal permeability in dextran sulfate sodium (DSS)-induced colitis and to determine the mechanism of the balsalazine-induced changes. Methods: Experimental colitis was induced in C57BL/6J mice by the administration of 5% DSS. Balsalazine was administered intragastrically at doses of 42, 141, and 423 mg/kg. The disease activity index (DAI) score was evaluated and colon tissue was collected for the assessment of histological changes. The amount of malondialdehyde (MDA) in the colon was determined, along with the activity of myeloperoxidase (MPO), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px). Mucosa from the small intestine was collected to determine the levels of tumor necrosis factor (TNF)-α and interferon (IFN)-γ. The mucosa was ultrastructurally examined with transmission electron microscopy and intestinal permeability was assayed using Evans blue. Results: Balsalazine was found to reduce the DAI score and the histological index (HI) score, decrease the MDA content and the activity of MPO, and increase the activity of SOD and GSH-Px in colitis mice. At the same time, balsalazine ameliorated microvillus and tight junction structure, resulting in a decrease in the amount of Evans blue permeating into the intestinal wall and the levels of TNF-α and IFN-γ in colitis mice. Conclusion: In colitis mice, the anti-colitis effect of balsalazine results in a decrease in intestinal mucosal permeability. The mechanism of this effect is partly associated with balsalazine's antioxidative and anti-inflammatory effects.

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Balsalazide is superior to mesalamine in the time to improvement of signs and symptoms of acute mild-to-moderate ulcerative colitis

Cited by 9 publications

References 0 publications

Once daily MMX mesalazine for the treatment of mild‐to‐moderate ulcerative colitis: a phase II, dose‐ranging study

Once daily MMX mesalazine for the treatment of mild‐to‐moderate ulcerative colitis: a phase II, dose‐ranging study

Ulcerative Colitis Practice Guidelines in Adults: American College of Gastroenterology, Practice Parameters Committee

Balsalazine decreases intestinal mucosal permeability of dextran sulfate sodium-induced colitis in mice

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