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Which 5-ASA?
  1. J C Mansfield
  1. Royal Victoria Infirmary, Newcastle NE1 4LP, UK;

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I read Dr Travis’ therapy update (

) with interest; the topic is timely in a market about to be challenged by new generic mesalazine brands. I note the choice of time dependent mesalazine (Pentasa) but, if mesalazine is to be relied upon exclusively, some evidence suggests Pentasa may not be the best choice. The recent study by Kruis and colleagues1 in the maintenance of remission in ulcerative colitis (UC) found that with Pentasa 1.5 g/day, the six month remission rate was 56.8% compared with 77.5% with balsalazide 3 g twice daily (p=0.045).

The assertion that the advantages of the azo bond delivery to the distal colon can be matched by simply increasing the dose of pH dependent (Asacol) or time dependent release (Pentasa) has not been …

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  • Conflict of interest: The author has accepted hospitality from the manufacturers of all of the current 5-ASA preparations, and sat on an advisory panel for Shire.