Exacerbation of chronic ulcerative colitis with mesalamine

Sturgeon, John B.; Bhatia, Paramjit; Hermens, Donald J.; Miner, Philip B.

doi:10.1016/0016-5085(95)90154-x

Cited by 37 publications

(21 citation statements)

References 20 publications

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“…5-ASA are mostly safe and effective, but they sometimes bring about exacerbation due to allergic reaction against 5-ASA. To date, 5-ASA intolerance has been reported in some case series, [2][3][4][5][6][7][8] but there are no reports on the characteristic clinical course with detailed analysis of laboratory data in a larger number of patients.…”

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confidence: 99%

5‐Aminosalicylate intolerance causing exacerbation in pediatric ulcerative colitis

Shimizu

Arai

Tang

et al. 2017

Pediatrics International

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confidence: 99%

5‐Aminosalicylate intolerance causing exacerbation in pediatric ulcerative colitis

Shimizu

Arai

Tang

et al. 2017

Pediatrics International

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“…In addition, a small subset of patients (<5% in adults, 12% in pediatric patients) may develop paradoxical worsening of colitis-type symptoms due to a hypersensitivity reaction. 67,68 When treating patients with suboptimal response to standard-dose mesalamine, the potential small benefit of escalating to high-dose mesalamine should be weighed against the potential risk of delaying alternative, more effective therapy, such as corticosteroids, immunosuppressive, and/or biologic therapy.…”

Section: Questionmentioning

confidence: 99%

AGA Technical Review on the Management of Mild-to-Moderate Ulcerative Colitis

et al. 2019

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Most patients with ulcerative colitis (UC) have mild-tomoderate disease activity, with low risk of colectomy, and are managed by primary care physicians or gastroenterologists. Optimal management of these patients decreases the risk of relapse and proximal disease extension, and may prevent disease progression, complications, and need for immunosuppressive therapy. With several medications (eg, sulfasalazine, diazo-bonded 5-aminosalicylates [ASA], mesalamines, and corticosteroids, including budesonide) and complex dosing formulations, regimens, and routes, to treat a disease with variable anatomic extent, there is considerable practice variability in the management of patients with mild-moderate UC. Hence, the American Gastroenterological Association prioritized clinical guidelines on this topic. To inform clinical guidelines, this technical review was developed in accordance with the Grading of Recommendations Assessment, Development and Evaluation framework for interventional studies. Focused questions included the following: (1) comparative effectiveness and tolerability of different oral 5-ASA therapies (sulfalsalazine vs diazo-bonded 5-ASAs vs mesalamine; low-(<2 g) vs standard (2-3 g/d) vs high-dose (>3 g/d) mesalamine); (2) comparison of different dosing regimens (once-daily vs multiple times per day dosing) and routes (oral vs rectal vs both oral and rectal); (3) role of oral budesonide in patients mild-moderate UC; (4) comparative effectiveness and tolerability of rectal 5-ASA and corticosteroid formulations in patients with distal colitis; and (5) role of alternative therapies like probiotics, curcumin, and fecal microbiota transplantation in the management of mild-moderate UC.

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“…Patients intolerant to one particular 5-ASA formulation may tolerate another 5-ASA medication [66]. Flares of diarrhea and other typical IBD symptoms have been noted as adverse events with both sulfasalazine and mesalamine [66][67][68][69][70][71][72][73][74]. Although the exact mechanism behind these adverse events remains unclear, in some cases there seemed to be true hypersensitivity colitis [69][70][71][72]74].…”

Section: Identifying Drug Intolerances and Side-effectsmentioning

confidence: 99%