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Inducing and Maintaining Remission in Ulcerative Colitis: Role of High-dose, Extended-release Mesalamine

Kao, James MD; Kwok, Karl MD; Das, Kiron M. MD, PhD

Journal of Clinical Gastroenterology: September 2010 - Volume 44 - Issue 8 - p 531-535
doi: 10.1097/MCG.0b013e3181db1a61
ALIMENTARY TRACT: Clinical Review
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In mild-to-moderate inflammatory bowel disease, particularly ulcerative colitis, 5-aminosalicylic acid (5-ASA) remains a cornerstone of therapy. Sulfasalazine, originally synthesized in 1940 as an arthritis treatment for Sweden's King Gustaf V, is an azo-linked compound between 5-ASA and sulfapyridine. This medication was soon discovered to be effective in treating ulcerative colitis. However, dose-related side effects of the sulfapyridine moiety led to considerable effort in developing medications to deliver 5-ASA to the desired parts of the intestine. The newest generation of 5-ASA medications allows high-dose medication delivery with decreased pill burden, thereby improving patient compliance. This review will describe the pharmacokinetics of various 5-ASA preparations, particularly focusing on high-dose formulations and their role in therapy; will examine current scientific literature; and will review clinical outcomes and safety profiles.

Division of Gastroenterology and Hepatology, Department of Medicine, Crohn's and Colitis Center of New Jersey, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ

Reprints: Kiron M. Das, MD, PhD, Division of Gastroenterology and Hepatology, Department of Medicine, Crohn's and Colitis Center of New Jersey, UMDNJ-Robert Wood Johnson Medical School, 1 Robert Wood Johnson Place, MEB 478, New Brunswick, NJ 08903 (e-mail: daskm@umdnj.edu).

Conflict of Interest Disclosure Statement/Funding Declaration Statement: All the authors have nothing to disclose.

© 2010 Lippincott Williams & Wilkins, Inc.