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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pharmacol Ther. Nov 6, 2015; 6(4): 137-144
Published online Nov 6, 2015. doi: 10.4292/wjgpt.v6.i4.137
Mesalazine preparations for the treatment of ulcerative colitis: Are all created equal?
Bei Ye, Daniel R van Langenberg
Bei Ye, Daniel R van Langenberg, Department of Gastroenterology, Eastern Health, Victoria 3128, Australia
Bei Ye, Daniel R van Langenberg, Eastern Health Clinical School, Monash University, Victoria 3128, Australia
Author contributions: Ye B performed the literature review and wrote the manuscript; van Langenberg DR revised the manuscript.
Conflict-of-interest statement: No conflict-of-interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Dr. Daniel R van Langenberg, Department of Gastroenterology, Eastern Health, Arnold Street, Box Hill, Victoria 3128, Australia.
Telephone: +61-3-98953000 Fax: +61-3-98999137
Received: May 16, 2015
Peer-review started: May 20, 2015
First decision: July 27, 2015
Revised: August 24, 2015
Accepted: October 12, 2015
Article in press: October 13, 2015
Published online: November 6, 2015

Oral mesalazine (also known as mesalamine) is a 5-aminosalicylic acid compound used in the treatment of mild to moderate ulcerative colitis, with high rates of efficacy in induction and maintenance of remission. The therapeutic effect of mesalazine occurs topically at the site of diseased colonic mucosa. A myriad of oral mesalazine preparations have been formulated with various drug delivery methods to minimize systemic absorption and maximise drug availability at the inflamed colonic epithelium. It remains unclear whether different oral mesalazine formulations are bioequivalent. This review aims to evaluate the differences between mesalazine formulations based on the currently available literature and explore factors which may influence the selection of one agent above another.

Keywords: Colitis, Ulcerative, Drug delivery systems, Mesalamine, Sulfasalazine, Therapeutic equivalency

Core tip: Various formulations of oral mesalazine are available for management of mild to moderate ulcerative colitis. Selection of the most appropriate formulation requires tailoring of the therapy to the individual and must incorporate factors such as disease distribution, efficacy, side effect profile, pill burden, patient preference and health economics.