Oral 5-aminosalicylic acid for induction of remission in ulcerative colitis

Discussion About Treatment of Ulcerative Colitis.

“…[3,4] As a group, the 5-ASAs were found to be significantly more effective than placebo for induction of remission, and within the limits of this analysis, there was no significant difference between the efficacy of sulfasalazine and the other 5-ASA therapies. For maintenance of remission, 5-ASAs were again found to be superior to placebo, but sulfasalazine was modestly more effective than the other 5-ASA therapies (odds ratio [OR], 1.29; 95% confidence interval [CI], 1.05-1.57).…”

“…The side-effect profiles of mesalamine and balsalazide are similar to placebo, whereas olsalazine and sulfasalazine are associated with an increased incidence of treatment withdrawal due to adverse events. [3,4] Sulfasalazine commonly causes headache, rash, and nausea, which are doserelated and may be due to the sulfa moiety, whereas olsalazine may have a side effect of dose-related diarrhea. [3,4] Although reported and concerning, the risk for interstitial nephritis, pancreatitis, and other rare events is low for all of the aminosalicylates.…”

“…[3,4] Sulfasalazine commonly causes headache, rash, and nausea, which are doserelated and may be due to the sulfa moiety, whereas olsalazine may have a side effect of dose-related diarrhea. [3,4] Although reported and concerning, the risk for interstitial nephritis, pancreatitis, and other rare events is low for all of the aminosalicylates. Nonetheless, current guidelines do suggest "periodic" renal function assessment while on 5-ASA therapy.…”

Optimizing clinical use of mesalazine (5-aminosalicylic acid) in inflammatory bowel disease

“…Meta-analysis of high-quality studies comparing oral 5-ASA to placebo for induction of UC remission showed that 5-ASA was superior with a pooled odds ratio of 2, but was no better than the less expensive parent compound, salazopyrin [Sutherland et al 1993]. An updated metaanalysis that included more studies confirmed this initial impression [Sutherland and MacDonald, 2003]. Biddle and Miner assessed the use of 5-ASA enemas for active left-sided UC in 90 patients who were previously unresponsive or intolerant to conventional therapy [Biddle and Miner, 1990].…”

Systematic review: steroid withdrawal in anti‐TNF‐treated patients with inflammatory bowel disease

“…[1][2][3][4] Mesalazine (mesalamine) is the initial treatment for mild-to-moderate UC. [5][6][7] After this regimen fails, corticosteroids and immunosuppressants are initiated. [8][9][10][11][12][13][14] Finally, at the top of the pyramid, anti-TNF is currently widely established for both CD and UC patients.…”