5-Aminosalicylic acid / Mesalazine & Ulcerative Colitis (UC)

In the context of 5-Aminosalicylic acid / Mesalazine & Ulcerative Colitis (UC), both the FDA and EMA have approved 5-Aminosalicylic acid / Mesalazine for the treatment of ulcerative colitis (UC).

5-Aminosalicylic acid / Mesalazine is preferred for patients with mild to moderate Ulcerative Colitis (UC). Research indicates with high certainty that 5-ASA is more effective than a placebo for maintaining therapy in ulcerative colitis (UC). However, it is also evident that 5-ASA is less effective when compared to sulfasalazine. There appears to be little or no difference between 5-ASA and placebo, as well as between 5-ASA and sulfasalazine, in terms of commonly reported adverse effects such as flatulence, abdominal pain, nausea, diarrhea, headache, and dyspepsia. Additionally, taking oral 5-ASA once daily offers a similar balance of benefits and risks as conventional dosing for maintaining remission in quiescent UC (1, 2, 3, 4). However, approximately 30% of patients either do not respond to this treatment or gradually lose its efficacy over time (5, 6).

References:

(1) Sandborn et al. 2012 Gastroenterology 143: 1218-26
(2) Ungaro et al. 2017 Lancet 389: 1756-70
(3) Hu et al. 2021c Front. Med. 8: 766126
(4) Murray et al. 2020b Cochrane Database of Systematic Reviews 8: CD000544
(5) Bernstein et al. 2010 Inflamm. Bowel Dis 16: 112-124
(6) Marti-Aguado et al. 2019 U Eur Gastroenterol J 7: 1042-1050