| Theme | Therapeutic strategy for ulcerative colitis ; from standard to up-to-date | |
|---|---|---|
| Title | 5-aminosalicylic acids for ulcerative colitis : Re-evaluation of traditional therapies | |
| Publish Date | 2011/05 | |
| Author | Yoshitaka Ueno | Department of Endoscopy, Hiroshima University Hospital |
| Author | Shinji Tanaka | Department of Endoscopy, Hiroshima University Hospital |
| Author | Kenta Nagai | Department of Gastroenterology, Hiroshima University Hospital |
| Author | Rie Hanaoka | Department of Gastroenterology, Hiroshima University Hospital |
| Author | Toshiko Onitake | Department of Gastroenterology, Hiroshima University Hospital |
| Author | Kazuaki Chayama | Department of Gastroenterology, Hiroshima University Hospital |
| [ Summary ] | The current first-line therapy for the induction and maintenance of remission of mild-to-moderate ulcerative colitis (UC) is oral and/or topical mesalazine. Sulfasalazine, a prodrug consisting of a sulfapyridine linked to 5-ASA, was the first available oral mesalazine formulation and has been in use for nearly 60 years. Due to adverse events associated with sulfapyridine moiety, other sulfa-free formulations of 5-ASA were developed. These include the time-dependent release (Pentasa, Kyorin) and pH-dependent release (Asacol, Zeria) formulations. Although the mechanisms of 5-ASA action are unknown, they are thought to be topical. Since 5-ASA formulations are administered multiple times per day, patients often fail to adhere to multiple dose regimens. Patients need to understand that the disease will flare up without continuous maintenance therapy. Another key component of UC treatment plans is the addition of rectal 5-ASA therapies. Although compliance can be very poor with topical therapies, there is a large body of evidence showing that the use of combination therapies provides a faster induction of remission than oral therapies alone. Despite the already established usefulness of these drugs, there is new data emerging to help physicians optimize efficacy, safety, dosing, and adherence to 5-ASA therapies. |
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