| Theme | Advanced Therapy Ulcerative Colitis | |
|---|---|---|
| Title | Medical Treatment with Salazosulfapyridine for Ulcerative Colitis Patients | |
| Publish Date | 1997/09 | |
| Author | Tomoe Katsumata | Department of Internal Medicine, Kitasato University East Hospital |
| Author | Kiyonori Kobayashi | Department of Internal Medicine, Kitasato University East Hospital |
| [ Summary ] | It has been established that salazosulfapyridine (Salazopyrin, SASP) is a useful medicine for the treatment of ulcerative colitis, in both the active and the quiescent phase. Approximentely 70-80% of the ingested SASP reaches the colon, and the azo bond is cleaved by bacterial azoreductases liberating 5-aminosalicylic acid (5-ASA) and sulfapyridine (SP). The clinical benefits and the adverse effects of SASP are related to the total serum SP concentration, which is elevated in patients having the slow acetylater as compared to those with the rapid acetylater phenotype. Based on the metabolism and the adverse effects of SASP, practical SASP treatment for ulcerative colitis patients is discussed herein. Clinical benefits can be anticipated using 3 to 4.5g SASP daily in the active stage of ulcerative colitis. The frequency of adverse effects varies in reports from 6-33% in patients with ulcerative colitis. Several clinical data have proved the usefulness of maintenance therapy with 2g daily of SASP in the quiescent stage of ulcerative colitis. Recently, Moody (1996) reported that patients with ulcerative colitis who had stopped long-term treatment with SASP were significantly more likely to develop colorectal cancer than their compliant counterparts. Maintenance therapy in ulcerative colitis with SASP should be continued unless contraindicated by adverse effects. |
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