title: Long-term safety and tolerability of once-daily mesalamine granules in the maintenance of remission of ulcerative colitis.
abstract: BACKGROUND
  Ulcerative colitis (UC), a chronic, relapsing, and remitting inflammatory bowel disease, requires long-term treatment to maintain remission. In this study, the long-term safety and tolerability of mesalamine granules (MG) therapy was evaluated in the maintenance of UC remission. Previous prospective studies evaluating different oral mesalamine formulations have not exceeded a duration of 14 months.
  
  
  METHODS
  A phase 3, multicenter, 24-month, open-label extension study evaluating MG 1.5 g once daily in patients who achieved previous remission from mild to moderate UC was performed. Eligible patients had successfully participated in 1 of 2 previous 6-month double-blind, placebo-controlled trials or were new patients in remission. Safety assessments included monitoring of adverse events (AEs) and clinical laboratory tests. Risk of UC recurrence was assessed by the occurrence of UC-related AEs.
  
  
  RESULTS
  Of the 393 patients enrolled (280 from the double-blind studies; 113 new patients), 388 were included in the safety population. The most common AEs included nasopharyngitis (13.9%), headache (11.6%), and diarrhea (10.8%), and the incidence of these events was generally lower in the MG group versus historical placebo group from the double-blind studies. Pancreatic, renal, and hepatic AEs occurred in 23 patients (5.9%). The risk of UC-related AEs was low and was maintained for 24 months during the open-label study.
  
  
  CONCLUSIONS
  Once-daily MG has a favorable safety profile for the maintenance of remission for up to 2 years in patients with UC.
authors.affiliation: *Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; and †Salix Pharmaceuticals Inc., Raleigh, NC.
authors.forename: Gary R
authors.initials: GR
authors.lastname: Lichtenstein
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Barrett
authors.forename: Enoch
authors.initials: E
authors.lastname: Bortey
authors.forename: Craig
authors.initials: C
authors.lastname: Paterson
authors.forename: William P
authors.initials: WP
authors.lastname: Forbes
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D060046:Maintenance Chemotherapy; D008297:Male; D020714:Maximum Tolerated Dose; D019804:Mesalamine / Q000627:therapeutic use*; D008875:Middle Aged; D011379:Prognosis; D012074:Remission Induction; D012449:Safety; D013997:Time Factors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D019804:Mesalamine