© 2002 by Gut
THERAPY UPDATE
Which 5-ASA?
John Radcliffe Hospital, Oxford OX3 9DU, UK; simon.travis@orh.nhs.uk
Keywords: 5-aminosalicylic acid; ulcerative colitis; Crohn' disease; inflammatory bowel disease
| The first 150 words of the full text of this article appear below. |
When Asacol commands 65% of the UK market, can so many British gastroenterologists be wrong? Possibly. The market leader in France is Pentasa (72%) and is Salofalk in Germany (57%). In Canada it is Asacol (46%). Nevertheless, a Cochrane review of 11 trials involving 1598 patients showed that sulphasalazine was more effective than other 5-aminosalicylic acid (5-ASA) drugs for maintaining remission in ulcerative colitis (odds ratio (OR) 1.29, confidence interval (CI) 1.06–1.57).1 Diagnosis, disease location, activity, side effect profile, efficacy, and cost all affect the choice of 5-ASA.
5-ASA acts on and is metabolised by intestinal epithelial cells. Consequently, ulcerative colitis (a mucosal disease) is more susceptible to treatment by 5-ASA than transmural Crohn's disease. Mega doses of mesalazine (
4 g/day) may be an initial alternative to steroids for mild-moderately active ulcerative colitis and reduce the risk of relapse after small intestinal (but not colonic) resection for Crohn's disease.2
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This article has been cited by other articles:
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Mansfield, J C
(2003). Which 5-ASA?. Gut
52: 771-771
[Full Text]
eLetters:
Read all eLetters
- Pentasa may not be the optimal 5ASA
- John C Mansfield
- Gut Online, 7 Nov 2002 [Full text]
- Which 5ASA?
- Simon Travis
- Gut Online, 21 Dec 2002 [Full text]
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