The systemic load and efficient delivery of active 5‐aminosalicylic acid in patients with ulcerative colitis on treatment with olsalazine or mesalazine

Støa-Birketvedt, Grethe; Florholmen, Jon

doi:10.1046/j.1365-2036.1999.00483.x

Cited by 26 publications

(11 citation statements)

References 8 publications

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“…In addition, some 5‐ASA compounds (olsalazine, balsalazide) are not easily detected in urine 32–35 . Therefore, this method may have limited reliability as an adherence measure, particularly for partially adherent patients.…”

Section: Discussionmentioning

confidence: 99%

“…31 In addition, some 5-ASA compounds (olsalazine, balsalazide) are not easily detected in urine. [32][33][34][35] Therefore, this method may have limited reliability as an adherence measure, particularly for partially adherent patients. In terms of relevance to clinical management, urinary mesalazine measurement by HPLC is expensive, time-consuming and gives a picture of recent consumption only rather than being able to provide a longer term picture as is the case with glycosylated haemoglobin measurement for determining blood glucose levels in people with diabetes.…”

Section: Discussionmentioning

confidence: 99%

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An investigation of medication adherence to 5‐aminosalicylic acid therapy in patients with ulcerative colitis, using self‐report and urinary drug excretion measurements

Moshkovska

Stone

Clatworthy

et al. 2009

Aliment Pharmacol Ther

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

An investigation of medication adherence to 5‐aminosalicylic acid therapy in patients with ulcerative colitis, using self‐report and urinary drug excretion measurements

Moshkovska

Stone

Clatworthy

et al. 2009

Aliment Pharmacol Ther

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“…81 In 2 previous reports, serum concentrations of 5-ASA were higher in the mesalazine group compared with the olsalazine group. 88,89 In patients with IBD receiving maintenance 5-ASA therapy there was greater absorption and less acetylation of 5-ASA from mesalazine (Asacol) compared with sulfasalazine or olsalazine; however, this has not been shown to result in increased nephrotoxicity. 90 Finally, although it has been suggested that Pentasa may be less frequently associated with interstitial nephritis than other 5-ASAs, 8 and it has been noted that Asacol, Claversal, and Salofalk have a relatively higher dose-dumping effect than Pentasa with higher peak serum concentrations, theoretically contributing to potential nephrotoxicity.…”

Section: Type Of 5-asa Compound and Nephrotoxicitymentioning

confidence: 98%

5-Aminosalicylates and renal function in inflammatory bowel disease

Gisbert

González-Lama

Maté

2007

Inflammatory Bowel Diseases

199

144

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Nephrotoxicity has been described in some patients with inflammatory bowel disease (IBD) treated with 5-aminosalicylic acid (5-ASA). Studies with 5-ASA treatment in which serum creatinine or creatinine clearance was measured regularly show that nephrotoxicity is exceptional (mean rate of only 0.26% per patient-year). There have been several case reports, including 46 patients, of renal disease associated with 5-ASA treatment in patients with IBD. 5-ASA treatment-related nephrotoxicity is reported most often within the first 12 months, but also delayed presentation after several years has been shown. The absence of a clear relationship between 5-ASA dose and the risk of nephrotoxicity suggests that this complication is idiosyncratic rather than dose-related. Most of the patients with renal disease associated with 5-ASA treatment suffered interstitial nephritis, with symptoms and signs being nonspecific, which may delay detection for many months. The nephrotoxicity potential of mesalazine and sulfasalazine seems to be similar. The risk with different oral preparations of 5-ASA is probably too small to influence the choice of agent. Mesalazine should be withdrawn when renal impairment manifests in a patient with IBD; if this does not result in a fall in serum creatinine, then renal biopsy should be considered. A trial of high-dose steroid may be recommended in patients whose renal function does not respond to drug withdrawal. The optimal monitoring schedule of serum creatinine in patients receiving 5-ASA treatment remains to be established, as there is no evidence to date that either the test, or the frequency of testing, improves patient outcomes.

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“…Moreover, 5-ASA is acetylated to acetyl-S-ASA (Ac-5-ASA) in the epithelium of the small intestine and the colon. The capacity of acetylation in the epithelium is low in the small intestine, but high in the colon (3), which may explain the differences in the concentration of 5-ASA observed in blood and urine in various 5-ASA preparations (4,5). 5-ASA is structurally similar to aspirin (acetylsalicylic acid).…”

Section: Introductionmentioning

confidence: 99%

Glomerular and tubular renal functions after long-term medication of sulphasalazine, olsalazine, and mesalazine in patients with ulcerative colitis

et al. 2000

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To date there are only few reports evaluating the potential nephrotoxic reactions of the new 5-aminosalicylic acid (5-ASA) preparations in patients with ulcerative colitis (UC). The aim of this study was to screen the tubular and glomerular functions in patients with UC in maintenance treatment with either 5-ASA azo-compounds (sulphasalazine and olsalazine) or mesalazine. Patients with UC in clinical remission treated with either sulphasalazine, olsalazine, or mesalazine for more than 1 year were included in an open, single-blind retrospective Norwegian multicenter study. Serum and urine creatinine, serum and urine beta2-microglobulin, urine N-acetyl-beta-glucoseamidase (NAG), urine alkaline phosphatase, urine microalbumin, urine alanine amino peptidase, and urine beta2-microglobulin were measured. Fifty-two females and 75 males (n = 127), ages 20-69, were evaluated. Thirty-six patients were treated with sulphasalazine (mean treatment time 10.1+/-6.6 years [mean +/- SD]), 32 patients were treated with olsalazine (2.3+/-1.4 years), and 59 patients with mesalazine (3.2+/-2.0 years). At inclusion, there were no significant differences in the serum or urine values between the groups. In 17 patients (1 patient [3%] in the sulphasalazine group, 4 patients [13%] in the olsalazine group, and 12 patients [20%] in the mesalazine group), at least one abnormal serum and/or urine value was detected. After 10 years of treatment, only one abnormal value was found among the 19 patients in the sulphasalazine group. The abnormal values observed in the other groups indicated minor glomerular or tubular renal damage. In conclusion, long term sulphasalazine treatment appears to be safe and free of nephrotoxic side effects, whereas minor glomerular and tubular impairment are observed in a few patients treated with olsalazine and mesalazine.

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The systemic load and efficient delivery of active 5‐aminosalicylic acid in patients with ulcerative colitis on treatment with olsalazine or mesalazine

Cited by 26 publications

References 8 publications

An investigation of medication adherence to 5‐aminosalicylic acid therapy in patients with ulcerative colitis, using self‐report and urinary drug excretion measurements

An investigation of medication adherence to 5‐aminosalicylic acid therapy in patients with ulcerative colitis, using self‐report and urinary drug excretion measurements

5-Aminosalicylates and renal function in inflammatory bowel disease

Glomerular and tubular renal functions after long-term medication of sulphasalazine, olsalazine, and mesalazine in patients with ulcerative colitis

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