Oral 5-ASA therapy in ulcerative colitis: what are the implications of the new formulations?
5-aminosalicylic acid (5-ASA) is the standard first-line treatment for mild-to-moderate ulcerative colitis. A variety of 5-ASA delivery systems are available and in development, including both oral and rectal formulations; all of which aim to deliver the active drug to the colon while minimizing systemic absorption. Because the efficacy of most oral 5-ASA therapies is broadly similar, the appropriate selection of a given formulation often relies on other factors. This article explores the differences between oral 5-ASA formulations in terms of their delivery system, reviews the available data on oral 5-ASA treatment efficacy and tolerability, and examines the rationale for changing from one 5-ASA formulation to another if a patient does not respond to, or worsens on, their existing agent.
Sandborn
William J
WJ
Division of Gastroenterology and Hepatology, 200 First Street SW, Mayo Clinic, Rochester, MN 55905, USA. sandborn.william@mayo.edu
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage* / Q000493:pharmacokinetics; D002626:Chemistry, Pharmaceutical / Q000379:methods; D003093:Colitis, Ulcerative / Q000188:drug therapy* / Q000378:metabolism; D004333:Drug Administration Routes; D004339:Drug Compounding; D006801:Humans; D019804:Mesalamine / Q000008:administration & dosage* / Q000493:pharmacokinetics; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D019804:Mesalamine