Balsalazide in treating colonic diseases.
Balsalazide is the newer 5-aminosalicylic acid (5-ASA) prodrug which releases active 5-ASA only into the colon with minimal systemic absorption. The onset of action of this drug is variable, and it may take at least some days to reach clinical effectiveness. Clinical studies found balsalazide faster than mesalazine in the induction of remission, but balsalazide has no benefit compared with mesalazine in preventing relapse in the population selected. However, the high number of pills to take may affect the adherence to the treatment. This 5-ASA prodrug may be effectively used also in patients unable to tolerate other mesalamine compounds for non-hypersensitivity reasons. The costs of balsalazide capsules seem to be lower for the health system, both considering total direct healthcare costs and better outcomes, compared with patients treated with oral mesalazine. Finally, there is also some recent evidence that balsalazide may be effectively used, in combination with probiotics, in treating acute uncomplicated diverticulitis is the colon.
Tursi
Antonio
A
Servizio di Gastroenterologia Territoriale, DSS n 4, ASL BAT, Via Torino, 49, Andria, Italy. antotursi@tiscali.it
D003093:Colitis, Ulcerative / Q000188:drug therapy; D003108:Colonic Diseases / Q000188:drug therapy*; D005765:Gastrointestinal Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D006801:Humans; D019804:Mesalamine / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D010659:Phenylhydrazines / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D011355:Prodrugs / Q000493:pharmacokinetics / Q000627:therapeutic use*; D016896:Treatment Outcome
D005765:Gastrointestinal Agents; D010659:Phenylhydrazines; D011355:Prodrugs; D019804:Mesalamine; C038637:balsalazide