Mesalazine use tactics in the ulcerative colitis patients
Abstract
Aim of the lecture. To specify indications for the administration of the 5-aminosalicylic acid (5-АSA) in the patients with ulcerative colitis (UC) and to discuss the possibility of correlation between the body mass index, the disease activity and reasonability for the prescription of the mesalazine (Pentasa) as a monotherapy.
Key points. 5-АSA is the first line drug for the UC patients. The efficacy has been demonstrated in a huge number of studies, the indications for the administration have been determined and are dependent on the disease activity index. 5-АSA are used in moderate rate of the inflammatory activity. This article discusses the question of the possible relation between the body mass loss during the disease, www.m-vesti.ru and the body mass index as the additional factors for the determining of the pathological process activity and the indications for the prescription of the 5-АSA drugs. The article points out the possibility of the mesalazine rectal suppositories use for proctitis in the patients with UC that increases the adhesion of the patients to the treatment.
Conclusion. Mesazaline is efficient in the UC patients with both distal as well as extended forms of the disease. The additional factor which determines the disease activity is probably the patients’ nutritional status which is expedient to be taken into account while selecting the therapy.
About the Authors
A. V. Korolev
I.M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
O. Z. Okhlobystina
I.M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
L. N. Androsova
I.M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
O. S. Shifrin
I.M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
References
1. Allgayer H. Sulphasalazine and 5-ASA compaunds. Gastroenterol Clin North Am 1992; 21 (3):643-58.
2. van Bodegraven AA, Boer RO, Lourens J, et al. Distribution of mesalazine enemas in active and quiescent ulcerative colitis. Aliment Pharmacol Ther 1996; 10:327-32.
3. Hanauer SB. Medical therapy for ulcerative colitis 2004. Gastroenterology 2004; 126(6):1582-1592.
4. Horn H, Preclir G, Stange E, et al. Modulation of arachinoid acid metabolism by olsalazine and other aminosalicylates in leukocytes. Scand J Gastroenterol 1991; 26:867-79.
5. Kamm MA, Sandborn WJ, Gassull M, et al. Once-daily, high-concentration MMX mesalamine in active ulcerative colitis. Gastroenterology 2007; 132 (l):66-75.
6. Koltz U. Clinical pharmacokinetics of sulphasalazine, its metabolites, and other of 5-aminosalicylic acid. Clin Pharm 1985; 10:285-302.
7. Kruis W, Kiudelis G, Racz I, et al. Once daily versus three times daily mesalazine granules in active ulcerative colitis: a double-blind, double-dummy, randomised, noninferiority trial. Gut 2009; 58:233-40.
8. Lamet M. A multicenter, randomized study to evaluate the efficacy and safety of mesalazine suppositories 1 g at bedtime and 500 mg twice daily in patients with active mild-to-moderate ulcerative proctitis. Dig Dis Sci 2011; 56:513-22.
9. Lauritsen K, Lauristen L, Bucrhave K, et al. Effects of topical 5-aminosalicylic acid on prostaglandin E2 and leukotriene B4 levels determined by equilibrium in vivo dialysis to rectum in relaping ulciritive colitis. Gastroenterogy 1986; 91 (4):837-44.
10. Marshall JK, Irvine EJ. Rectal corticosteroids versus alternative treatments in ulcerative colitis: a metaanalysis. Gut 1997; 40:775-81.
11. Marshall JK, Thabane M, Steinhart AH, et al. Rectal 5-aminosalicylic acid for induction of remission in ulcerative colitis. Cochrane Database Syst Rev 2010 [CD004115-CD004115].
12. Marteau P, Probert CS, Lindgren S, et al. Combined oral and enema treatment with Pentasa (mesalazine) is superior to oral therapy alone in patients with extensive mild/ moderate active ulcerative colitis: a randomised, double blind, placebo controlled study. Gut 2005; 54:960-5.
13. Munkholm P, Michetti P, Probert CS, et al. Practice in the management of mild-to-moderately active ulcerative colitis and achieving maintenance of remission using mesalazine. Eur J Gastroenterol Hepatol 2010; 22:912-6.
14. Regueiro M, Loftus Jr EV, Steinhart AH, et al. Medical management of left-sided ulcerative colitis and ulcerative proctitis: critical evaluation of therapeutic trials. Inflamm Bowel Dis 2006; 12:979-94.
15. Safdi M, DeMicco M, Sninsky C, et al. A doubleblind comparison of oral versus rectal mesalazine versus combination therapy in the treatment of distal ulcerative colitis. Am J Gastroenterol 1997; 92:1867-71.
16. Sandborn WJ, Kamm MA, Lichtenstein GR, et al. MMX Multi Matrix System((R)) mesalazine for the induction of remission in patients with mild-to-moderate ulcerative colitis: a combined analysis of two randomized, doubleblind, placebo-controlled trials. Aliment Pharmacol Тhег 2007; 26 (2):205-15.
17. Stein RB, Hanauer SB. Medical therapy for inflammatory bowel disease. Gastroenterol Clin North Am 1999; 28 (2):297-321.
18. Sutherland L. Macdonald JK. Oral 5-aminosalicylic acid for induction of remission in ulcerative colitis. Cochrane Database Syst Rev 2006; (2):CD000543.
19. Sutherland L., Macdonald JK. Oral 5-aminosalicylic acid for maintenance of remission in ulcerative colitis. Cochrane Database Syst Rev 2006; (2):CD000544.
20. Svartz N. Salazopyrin, a new sulphanilamide preparation: A. Therapeutic results in ulcerative colitis. C. Toxic manifestation in treatment with sulphanilamide preparation. Acta Med Scand 1942; 110:557-90.
Review
For citations:
Korolev A.V., Okhlobystina O.Z., Androsova L.N., Shifrin O.S. Mesalazine use tactics in the ulcerative colitis patients. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2013;23(1):52-56. (In Russ.)
Views:
59
Email this article 
