Mesalamine in the Initial Therapy of Ulcerative Colitis

Gastroenterol Clin North Am. 2020 Dec;49(4):689-704. doi: 10.1016/j.gtc.2020.07.002. Epub 2020 Sep 25.

Abstract

Inflammatory bowel disease is a chronic disorder of intestinal inflammation and includes Crohn's disease and ulcerative colitis. The goal of therapy is to induce and maintain remission, which is achieved with conventional therapies. Mesalamine is considered a first-line therapy for ulcerative colitis. Clinical trials have confirmed its efficacy and safety in patients with mild to moderate ulcerative colitis. Doses of more than 2.4 g/d achieve significantly higher rates of clinical and endoscopic remission, with a decreased risk of relapse. Serious adverse effects are rare, but nonadherence is common. Mesalamine is considered safe in pregnancy, excluding formulations with dibutyl phthalate.

Keywords: Chronic disorder; Crohn’s disease; Dibutyl phthalate; Endoscopic healing; Inflammatory bowel disease; Therapy; Ulcerative colitis.

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Colitis, Ulcerative / drug therapy*
  • Colitis, Ulcerative / pathology
  • Dibutyl Phthalate
  • Drug Compounding
  • Endoscopy, Gastrointestinal
  • Female
  • Humans
  • Maintenance Chemotherapy
  • Male
  • Mesalamine / administration & dosage
  • Mesalamine / adverse effects
  • Mesalamine / therapeutic use*
  • Pregnancy
  • Pregnancy Complications
  • Quality of Life
  • Remission Induction
  • Safety
  • Secondary Prevention

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Dibutyl Phthalate
  • Mesalamine