Mesalamine in the treatment and maintenance of remission of ulcerative colitis

Abstract

Ulcerative colitis (UC) is a chronic disease of the GI tract that is characterized by mucosal inflammation in the colon. Mesalamine (mesalazine) is a 5-aminosalicylic acid compound that is the first-line treatment for patients with mild-to-moderate UC. There are multiple formulations of mesalamine available, primarily differentiated by their means of delivering active mesalamine to the colon. Mesalamine has been demonstrated in randomized controlled trials to induce both clinical response and remission, and maintain clinical remission, in these patients. It has few serious adverse effects and is generally well tolerated by patients. The main areas of uncertainty with use of mesalamine in patients with UC center on the optimal dose for induction of response, how to maintain patient adherence and the role of mesalamine in cancer chemoprophylaxis. Generic forms of mesalamine have yet to be approved by regulatory bodies in the USA.

Development and Optimization of Sustained Release in Situ Gel for the Treatment of Ulcerative Colitis

“…Mesalamine had been demonstrated in randomized controlled trials to induce both clinical response and remission, and maintain clinical remission. [4] Poloxamers are a family of triblock copolymers consisting of two hydrophilic blocks of polyoxyethylene separated by a hydrophobic block of polyoxypropylene, which form micelles at low concentrations and form clear thermally reversible gels at high concentrations. Hydroxypropyl Methyl Cellulose (HPMC) E50 was added to in situ gels to improve the mucoadhesive and mechanical properties of formulations and to prolong the residence time.…”

Evaluación de coste-efectividad mediante análisis teórico de minimización de costes del uso de dos mesalazinas gastrorresistentes de liberación prolongada en el manejo de la colitis ulcerosa en España

“…El tratamiento de los pacientes con CU de leve a moderada se basa fundamentalmente en el uso de derivados del ácido 5-aminosalicílico (5-ASA) 4,11 . En la actualidad existe amplia evidencia científica que avala la eficacia, la efectividad y la seguridad de la mesalazina como primera línea de tratamiento, tanto en el momento del brote como para el mantenimiento de la remisión en la CU de leve a moderada [12][13][14][15][16] . Por otro lado, se ha observado un aumento del coste total de esta enfermedad 17 , con gran variabilidad entre los diferentes países europeos 18 , y el impacto del diferente manejo de los derivados del 5-ASA en cada uno de estos países ha resultado ser un factor determinante 19 .…”

Co-administration of α-lipoic acid and cyclosporine aggravates colon ulceration of acetic acid-induced ulcerative colitis via facilitation of NO/COX-2/miR-210 cascade

“…Being a chronic relapsing and remitting disease; many drugs are used in ulcerative colitis patients during remission to maintain remission and prevent relapses (Ardizzone et al, 1997;Ham and Moss, 2012;Piodi et al, 2004;Powell-Tuck et al, 1981). Experimentally, ulcerative colitis has been induced in animals using a variety of chemicals that cause acute destruction of colon mucosa such as acetic acid (Mizoguchi, 2012).…”