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New lessons: classic treatments, expanding options in ulcerative colitis
Author(s) -
Hanauer S. B.
Publication year - 2006
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/j.1463-1318.2006.00988.x
Subject(s) - medicine , dosing , ulcerative colitis , adverse effect , inflammatory bowel disease , disease , incidence (geometry) , colitis , intensive care medicine , physics , optics
Ulcerative colitis (UC) of moderate severity is a common presentation in gastroenterological practice and a number of treatment options exist to rapidly and effectively induce remission. This review highlights how novel formulations and dosing regimens can ensure treatment success at a greater convenience for the patient with no increased risk of adverse effects. 5‐aminosalicyclic acid (5‐ASA) is well tolerated with a low incidence of adverse effects, and has a significant role in the management of UC. Different formulations of oral 5‐ASA are now available and allow targeted treatment to inflammatory areas of the small bowel and ascending colon. 5‐ASA is often initiated at a low dose for patients with mild to moderately active UC and with increasing doses for those who fail or have a poor response. 5‐ASA at high doses is increasingly being used as induction therapy for active UC, particularly in patients with recurrent and/or extensive disease. The recent ASCEND studies show that an induction dose of 5‐ASA of 4.8 g daily in patients with moderate UC is significantly more effective and resolves symptoms faster compared with a daily dose of 2.4 g. The evidence provided by the ASCEND studies support the rationale for a ‘top‐down’ dosing strategy for UC where more potent therapies are introduced at an earlier stage of moderately severe disease.