Long-term oral plus topical mesalazine in frequently relapsing ulcerative colitis

Frieri, Giuseppe; Pimpo, M.T.; Galletti, B.; Palumbo, Giancarlo; Corrao, Giovanni; Latella, Giovanni; Chiaramonte, M.; Caprilli, R.

doi:10.1016/j.dld.2004.09.017

Cited by 59 publications

(26 citation statements)

References 26 publications

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“…Marakhouski et al 38 reported that in patients who had not responded to 1.5 g of 5‐ASA, the remission rate could be improved from 42% to 68% by doubling the dose. Frieri et al 39 evaluated dose escalation with 5‐ASA in a cohort of 18 patients who had suffered 80 relapses over 2 years; increasing oral 5‐ASA and added topical 5‐ASA reduced the relapse rate to eight episodes in the subsequent 2 years. Finally, in an RCT, rectal delivery in addition to oral therapy, in extensive UC, was shown to be an effective strategy to reduce disease activity and therefore avoid steroid therapy 41 …”

Section: Strategies For Dealing With Steroid Resistancementioning

confidence: 99%

Review article: steroid resistance in inflammatory bowel disease – mechanisms and therapeutic strategies

Creed

Probert

2007

Aliment Pharmacol Ther

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Summary Background Steroid resistance in inflammatory bowel disease presents a difficult clinical challenge. The advent of biological therapies coupled with an increasing understanding of the pathogenesis of inflammatory bowel disease has provided new therapeutic options. Methods We review the available literature of the mechanisms behind steroid resistance. In addition, we outline some of the options available for treating those patients who fail to respond adequately to glucocorticoids. Results Approximately 30% of patients prescribed glucocorticoids will not achieve clinical remission. Many such patients are offered immunosuppressive or, recently, biological agents. However, these agents are ineffective in a large proportion of patients. Immunosuppressive agents only bring 40–60% of patients into remission, and biological agents typically induce remission in just 40% of patients. In this review, the possible explanations for glucocorticoid resistance are discussed. Recent evidence suggests that in many patients it is mediated by interleukin‐2. Basiliximab, a biological agent that interrupts interleukin‐2 signalling, has shown significant benefit in early clinical studies. Conclusions Patients who fail to respond to steroid therapy should have alternative agents introduced in a timely fashion. Steroid refractory inflammatory bowel disease remains a difficult condition to treat, but new therapies and managements are emerging.

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Section: Strategies For Dealing With Steroid Resistancementioning

confidence: 99%

Review article: steroid resistance in inflammatory bowel disease – mechanisms and therapeutic strategies

Creed

Probert

2007

Aliment Pharmacol Ther

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“…Although the data available on the current mesalazine formulations with regard to colonic or mucosal levels are limited, 13,14,22 an inverse relationship between the plasma AUC and the mucosal concentration of mesalazine and its main metabolite N‐acetyl‐mesalazine (N‐ac‐5‐ASA) was reported by De Vos et al 22 for the slow‐release forms. These authors determined the intramucosal concentrations of 5‐ASA and N‐Ac‐5‐ASA in ileocolonic biopsy specimens from 61 patients with irritable bowel syndrome treated for 1 week with near equimolar doses of different slow‐release preparations of 5‐ASA (eudragit‐coated mesalazine or ethylcellulose‐coated mesalazine) or azo‐bound drugs (sulfasalazine, olsalazine).…”

mentioning

confidence: 99%

Is Once‐Daily Mesalazine Equivalent to the Currently Used Twice‐Daily Regimen? A Study Performed in 30 Healthy Volunteers

Gandia

Idier

Houin

2007

The Journal of Clinical Pharma

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A randomized, 2-way, crossover study was conducted in 30 volunteers to compare the pharmacokinetic profile of a new once-daily dosing regimen of mesalazine (1 x 4 g/d) with the current twice-daily dosage (2 x 2 g/d) used in many European countries. The 2 dosages were administrated orally for 8 days, separated by a 2-week washout. Plasma concentrations of mesalazine and N-acetyl-mesalazine were determined on days 1 and 8 by a validated high-performance liquid chromatography method and C(max), t(max), and AUCs calculated. The bioequivalence was obtained for a 90% confidence interval of the AUC(0-24h) ratio (test/reference) for mesalazine and N-acetyl-mesalazine on days 1 and 8, within the range of 0.80 to 1.25. The bioequivalence was demonstrated on day 1 for mesalazine and N-acetyl-mesalazine and on day 8 for mesalazine. As it is desirable to offer patients a preparation with a less frequent administration to enhance compliance, this once-daily regimen may be an attractive dosing option.

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“…32 More directly, a study of 18 patients with moderate to severe UC in Italy reported that total hospitalization days decreased from 93 to 0 days when disease activity was reduced to remission or a mildly active state. 42 Among all hospitalizations, the percentage of surgical hospitalizations varies substantially from country to country. Nguyen et al 33 The percentage of patients with UC requiring surgery during their lifetime is strikingly high.…”

mentioning

confidence: 99%

Systematic review: the costs of ulcerative colitis in Western countries

Cohen

et al. 2010

Aliment Pharmacol Ther

245

151

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Long-term oral plus topical mesalazine in frequently relapsing ulcerative colitis

Cited by 59 publications

References 26 publications

Review article: steroid resistance in inflammatory bowel disease – mechanisms and therapeutic strategies

Review article: steroid resistance in inflammatory bowel disease – mechanisms and therapeutic strategies

Is Once‐Daily Mesalazine Equivalent to the Currently Used Twice‐Daily Regimen? A Study Performed in 30 Healthy Volunteers

Systematic review: the costs of ulcerative colitis in Western countries

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