5-Amino-salacylic acid (5-ASA) is up to now the treatment of choice in theinduction and maintenance of remission of mild-to-moderate ulcerative colitis(UC). Sulfasalazine, despite similar efficacy, is hampered by more side effects, but in presence of peripheral arthopaties it remains the treatment of choice. Thenew delayed release MMX formulation seems to be promising in reducing compliance problems, but further studies are warranted to show the superiority of new MMXformulation compared with the older formulations of 5-ASA. Some trials evaluated also the efficacy and safety of once-daily dosing of older 5-ASA formulations in maintenance of remission, finding a greater adherence to therapy in the groupgiven the once daily regimen, compared with the classic twice daily groups.Regarding the efficacy of alternative treatment such us probiotics andantibiotics, the current data are not sufficient to promote their use in clinicalpractice. Clinical evidence supports the use of topical 5-ASA in active mild tomoderate distal UC showing superior efﬁcacy to placebo, topical corticosteroids, and oral 5-ASA. A combination of oral and rectal 5-ASA produces additionalefﬁcacy in both limited and extensive UC. Topical 5-ASA formulations areeffective also for the maintenance of remission, however long term treatment may not be acceptable to many patients. Other topical drugs (E. Coli Nissle,propionyl-L-carnitine, butyrate, tacrolimus, rosiglitazone) have beeninvestigated with conflicting results. The possible chemopreventive role of long term treatment with 5-ASA strengthens the indication to the long term use of5-ASA.
|Numero di pagine||10|
|Rivista||Current Drug Targets|
|Stato di pubblicazione||Published - 2011|
All Science Journal Classification (ASJC) codes
- Molecular Medicine
- Drug Discovery
- Clinical Biochemistry