Treatment of Ulcerative Colitis With High-Dose 5-Aminosalicylic Acid Enemas

Absorption of 5‐aminosalicylic acid from colon and rectum.

“…The similar permeability pattern in the different areas of the large bowel may support the assumption that increased efficacy towards colitis engaging the right colon may be achieved by therapeutic regimens providing large amounts of 5-ASA to the lumen there, in line with the results after high dose 5-ASA enema treatment in proctosigmoiditis (Azad Khan et al, 1977;Campieri et al, 1981).…”

“…Distal ulcerative colitis can be effectively treated with 5-aminosalicylic acid (5-ASA/mesalazine) if applied rectally (Azad Khan et al, 1977;vanHees et al, 1980;Campieri et al, 1981;Danish 5-ASA Group, 1987).…”

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“…Correspondingly, very low trough plasma concentrations of drug and metabolite were found (124). On the other hand, high plasma concentrations of drug and metabolite following treatment with an enema of 4000 mg (18) in contrast to any earlier measured concentrations in man. Although the dose in this study was higher than earlier applied, the results might indicate special characteristics of rectal/distdl colonic absorption of 5-ASA and may give cause to concern as to possible systemic toxicity from topical treatment ( I 7).…”

GRG Profiles: Lawrence S. Friedman

“…He also allowed me to pursue clinical, rather than basic, research, which emanated from problems I encountered in practice. For example, a study from Italy had just reported that treatment with enemas containing 5-aminosalicylic acid (mesalamine) was effective in ulcerative proctitis [3], and I was able to obtain 5-aminosalicylic acid, create my own enema formulation, and conduct a study that led to the publication of one of the first randomized controlled studies comparing 5-aminosalicylic acid enemas with standard glucocorticoid enemas [4].…”