Can oral 5-aminosalicylic acid be administered once daily in the treatment of mild-to-moderate ulcerative colitis? A meta-analysis of randomized-controlled trials

Abstract

The present work showed that oral delayed-release mesalazine administered as a single or a divided dose demonstrated a good safety profile, which was well tolerated and effective as either maintenance or induction treatment. High clinical and/or endoscopic remission rates can be achieved with once-daily dosing.

Review article: integrating budesonide‐MMX into treatment algorithms for mild‐to‐moderate ulcerative colitis

“…The benefit of oral 5‐ASA vs. placebo has been demonstrated for mucosal healing (RR = 0.69, 95% CI 0.62–0.77), whatever the frequency of administration (once or multiple times daily), in induction ( P = 0.23) and maintenance ( P = 0.78) . Endoscopic remission rate with combined oral and topical 5‐ASA therapy has not been compared with that seen with monotherapy.…”

“…Overall, toxicities related to 5‐ASA are very rare in clinical practice. In RCTs, of 30% of patients who reported AE related to oral 5‐ASA, only 1–2% were severe . The main symptoms associated with oral mesalazine include flatulence, abdominal pain, nausea, diarrhoea and worsening headache.…”

Once daily vs multiple daily mesalamine therapy for mild to moderate ulcerative colitis: a meta‐analysis

“…Several previous systematic reviews and meta‐analyses have compared OD with MD dosing of oral mesalamine . To our knowledge, however, no previous meta‐analysis has studied the administration of mesalamine suppositories and the present study is the first to include trials comparing OD with MD suppositories.…”

“…Zhu et al . showed that OD dosing can achieve higher remission rates not only for inducing but also for maintaining remission. Tong et al .…”

“…Although the previous reviews showed that OD can be as effective and safe as MD dosing in maintaining and inducing remission, there was a minor difference. Zhu et al [30] showed that OD dosing can achieve higher remission rates not only for inducing but also for maintaining remission. Tong et al [32] stated that OD mesalamine can achieve a better efficacy than MD dosing in inducing remission than in maintaining remission (RR 0.80, 95% CI 0.64-0.99).…”