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Crohn's Disease
Published in Charles Theisler, Adjuvant Medical Care, 2023
Previous studies have proposed a protective role from supplementary dietary intake of PUFAs (EPA and DHA) in inflammatory bowel disease (IBD). The results are potentially comparable to the effects of mesalazine, which has clear efficacy in the treatment of acute ulcerative colitis and in the maintenance of its remission.6
Gastrointestinal diseases and pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Murtaza Arif, Anjana Sathyamurthy, Jessica Winn, Jamal A. Ibdah
Because of multiple side effects associated with the presumably inactive sulfapyridine moiety, both topical and oral agents that contain only 5-ASA have been developed. Topical therapy with 5-ASA (mesalamine) enemas is an effective treatment for acute proctitis or proctitis with left-sided colitis. In addition, several oral forms of 5-ASA (Pentasa®, Asacol®, and Dipentum®) have been released for treatment of both CD and UC. These drugs contain 5-ASA in formulations that prevent their premature absorption from the gastrointestinal tract. A number of studies have established the safety of oral and topical aminosalicylates in pregnancy (89–91). A meta-analysis of mesalamine formulations used during pregnancy demonstrated no increased risk for congenital malformations, stillbirths, spontaneous abortions, preterm delivery, or low birth weight with the use of mesalamine (92). Thus sulfasalazine and 5-ASA drugs can be used during pregnancy as in nonpregnant women with IBD.
Medical Treatment of IBD
Published in Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams, Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
Naveen Sharma, Michael R.B. Keighley, Severine Vermeire
Oral mesalazine 2.4 to 4.8 g daily or balsalazide 6.75 g daily is an effective first-line therapy. Topical mesalazine combined with oral mesalazine is more effective than oral therapy alone. Once daily dosing of mesalazine is at least as effective as twice or three times daily regimes.
Mesalazine Suppresses Proinflammatory Cytokines in Patients with Acute Anterior Uveitis Independently of HLA-B27
Published in Ocular Immunology and Inflammation, 2022
Nikola Smatlik, Nourhan Mortada, Martin Röcken, Amir S. Yazdi, Manfred Zierhut
Mesalazine (mesalamine, 5-ASA) without sulfasalazine has been also widely used in the treatment of inflammatory bowel disease and rheumatoid arthritis. Different mechanisms of mesalazine (5-ASA) action have been proposed, but the exact mechanism still remains poorly understood. Although its mode of action still remains cryptic, reactive oxygen intermediate (ROI) scavenging by neutrophils, monocytes, and macrophages are one supposed mechanism.13 ROIs are involved in the activation of nuclear factor kappa B (NFkB), with sulfasalazine being a potent inhibitor of NFkB.14,15 Later it was postulated that the anti-inflammatory effects of mesalazine (5-ASA) are mediated, at least in part, by peroxisome proliferator-activated receptor gamma (PPARγ).16 Some other possible mechanisms described include inhibition of the platelet-activating factor, and reduced ROS.17
Efficacy and safety of oral Pentasa (prolonged-release mesalazine) in mild-to-moderate ulcerative colitis: a systematic review and meta-analysis
Published in Current Medical Research and Opinion, 2021
Kristine Paridaens, John R. Fullarton, Simon P. L. Travis
For more than 30 years, mesalazine has been shown to be therapeutically effective and well-tolerated in the treatment of mild-to-moderate UC17,18 acting topically to reduce intestinal inflammation in proportion to its luminal concentration37. Of the various mesalazine formulations, Pentasa has a unique prolonged-release mechanism and is available at higher dosage strengths for simplified once daily dosing8. This SLR and meta-analysis provides an up-to-date and comprehensive assessment of the clinical evidence for the effectiveness of oral Pentasa in mild-to-moderate UC, analyzing data from 12 studies, including three that are currently unpublished, and 3674 patients treated with Pentasa (1154 enrolled in RCTs). The meta-analyses undertaken confirm the consistent efficacy and safety of oral Pentasa in treating both active UC and maintaining remission.
Advancements of compounds targeting Wnt and Notch signalling pathways in the treatment of inflammatory bowel disease and colon cancer
Published in Journal of Drug Targeting, 2021
Zhuonan Pu, Fang Yang, Liang Wang, Yunpeng Diao, Dapeng Chen
Mesalazine and its derivatives are widely used in IBD patients for treatment of relapses and maintenance of remission. Mesalazine modulates multiple biological pathways. During treatment with mesalazine in the context of colon cancer, phosphorylated β-catenin accumulates and nuclear translocation of β-catenin is inhibited to suppress Wnt signalling [92–94]. The mechanism by which mesalazine promotes phosphorylation of β-catenin remains unclear, but this process is mediated by various factors, including protein phosphatase 2A and KLF4 [95,96]. Mesalazine prevents the occurrence of colon cancer via suppression of the Wnt pathway [97]. ETC-159 and G007-LK have similar activity, but specifically inhibit porcupine receptor and tankyrase, respectively, to suppress the Wnt pathway [98–100].