Mesalamine Foam Enema<i>Versus</i>Mesalamine Liquid Enema in Active Left-Sided Ulcerative Colitis

Cortot, Antoine; Maetz, D; Degoutte, E; Delette, O; Meunier, Pierre J.; Tan, Gie; Cazals, Jean-Brice; Dewit, Olivier; Hébuterne, Xavier; Beorchia, S.; Grunberg, B; Leprince, Eric; D’Haens, G; Forestier, S.; Idier, Isabelle; Lémann, Marc

doi:10.1111/j.1572-0241.2008.02152.x

Cited by 58 publications

(43 citation statements)

References 24 publications

(34 reference statements)

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“…[15][16][17][18] 5-ASA foam preparations have a similar distribution pattern as compared to enemas. 19 5-ASA suppositories in a dosage of 1 g/day are the preferred therapy of mild to moderate proctitis.…”

Section: Introductionmentioning

confidence: 92%

“…The comparison between mesalamine foams and mesalamine liquid enema in patients with active left-sided ulcerative colitis showed a not significant lower remission rate induced by the foam formulations. 17 Despite of the fact that topical treatment may be more efficient than oral treatment a subgroup of patients does not feel comfortable to do the therapy on a daily basis. Therefore, there have been attempts for other galenic formulations to avoid the rectal administration.…”

Section: 32mentioning

confidence: 99%

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Topical therapy is underused in patients with ulcerative colitis

Seibold

Fournier

Beglinger

et al. 2014

Journal of Crohn's and Colitis

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The availability of new topical preparations for the treatment of left sided ulcerative colitis offers a therapy optimization for many patients. Rectal application of steroids and 5-aminosalicylic acid (5-ASA) is associated with fewer side effects and has a higher therapeutic efficacy in left-sided colitis as compared to a systemic therapy. Therefore, we were interested in the use of topical therapy in patients with ulcerative colitis. The key question was whether topical treatment is more frequently used than oral therapy in patients with proctitis and left sided colitis. Data of 800 patients of the Swiss IBD cohort study were analyzed. Sixteen percent of patients of the cohort had proctitis, 21% proctosigmoiditis and 41% pancolitis. Topical therapy with 5-ASA or corticosteroids was given in 26% of patients with proctitis, a combined systemic and topical treatment was given in 13%, whereas systemic treatment with 5-ASA without topical treatment was given in 29%. Proportion of topical drug use decreased with respect to disease extension from 39% for proctitis to 13.1% for pancolitis (P = 0.001). Patients with severe colitis received a significantly higher dose of topical 5-ASA than patients in remission.

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Section: Introductionmentioning

confidence: 92%

Section: 32mentioning

confidence: 99%

Topical therapy is underused in patients with ulcerative colitis

Seibold

Fournier

Beglinger

et al. 2014

Journal of Crohn's and Colitis

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“…19 Foam retention was shown to be significantly better than liquid retention and may be the preferred formulation in patients with a severely inflamed rectum. 19 Topical therapy and the different formulations should be explained to patients and explored whenever possible.…”

Section: -Asa In Ucmentioning

confidence: 99%

The Use of 5-Aminosalicylic Acid in Children and Adolescents With Inflammatory Bowel Disease

Sokollik

Fournier

Rizzuti

et al. 2018

Journal of Clinical Gastroenterology

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Background: In ulcerative colitis (UC) 5-aminosalicylic acid (5-ASA) is recommended as primary therapy for mild to moderate disease. Topical 5-ASA has been proven especially effective. In Crohn’s disease (CD) the evidence for a beneficial role of 5-ASA is weak. We investigated the use of topical and systemic 5-ASA therapy in children and adolescents with inflammatory bowel disease. Materials and Methods: Data of patients younger than 18 years, registered between April 2008 and December 2015 in the Swiss Inflammatory Bowel Disease Cohort, were analyzed. Results: Three hundred twenty pediatric inflammatory bowel disease patients were included; 189 with CD and 131 with UC. Over one third of UC patients [51 (39%)] received topical 5-ASA therapy and 43 (33%) received combination therapy during their disease course. UC patients with left-sided colitis or proctitis were more likely to receive topical or combination therapy as compared with patients with pancolitis (P<0.001 and <0.001, respectively). An increase in the use of topical 5-ASA therapy in UC patients was noted over time from 5% to 38%. Forty-seven percent of CD patients were treated with oral 5-ASA during their disease course. The usage was stable over time at approximately 15% to 20%. Conclusions: In recent years a very positive trend showing an increase in topical 5-ASA therapy in children and adolescents with UC has been observed. However topical therapy is still used with relative low frequency, especially in patients with a more extensive disease. Conversely, despite weak evidence supporting 5-ASA use in CD patients it has been frequently prescribed. Physicians should continue to encourage their UC patients to use topical therapy.

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“…Comparative studies between mesalazine foam and mesalazine enemas show comparable efficacy [54,55,56,57] (table 5). The comparison of two different mesalazine rectal foam formulations, i.e.…”

Section: Various Rectal Formulations Of Mesalazine and Of Budesonidementioning

confidence: 99%

Topical Therapy

Groß¹

2012

Dig Dis

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Topical therapy with mesalazine and/or corticosteroids is the standard treatment for patients with distal ulcerative colitis. Rectal mesalazine is more effective than rectal systemically active corticosteroids or topically active corticosteroids like budesonide. In patients with mild to moderately active distal ulcerative colitis, topical mesalazine is therefore the treatment of choice. Doses of 1 g or higher are equally effective. The period of treatment is important (4 weeks are more effective than 2 weeks). In the case of nonresponse or nontolerability of rectal mesalazine, rectal budesonide is indicated. The standard dose of budesonide is 2 mg/day. This does not usually induce any corticosteroid-associated adverse events. Treatment with rectal mesalazine plus rectal topically active corticosteroids is even more effective than treatment with either substance alone. To overcome adherence problems with rectal therapy, rectal foam preparations have been developed which are usually better tolerated than enemas.

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Mesalamine Foam EnemaVersusMesalamine Liquid Enema in Active Left-Sided Ulcerative Colitis

Cited by 58 publications

References 24 publications

Topical therapy is underused in patients with ulcerative colitis

Topical therapy is underused in patients with ulcerative colitis

The Use of 5-Aminosalicylic Acid in Children and Adolescents With Inflammatory Bowel Disease

Topical Therapy

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