Mesalazine: Oral, rectal oder both?
Video report presented by Prof. Wolfgang Kruis, Ev. Krankenhaus Kalk, Cologne, Germany, at the Symposium 205 "New Treatment Targets in Gut and Liver Diseases" in Lucerne, Switzerland, October 21 – 22, 2016.
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A symposium sponsored by the Falk Foundation entitled “New Treatment Targets in Gut and Liver Diseases” was held in October 2016. Important findings with regard to optimized use of proven therapeutic options in chronic inflammatory bowel diseases were a main topic. Professor Dr. Wolfgang Kruis from Cologne spoke about the importance of mesalazine in ulcerative colitis. Mesalazine has been the standard therapy in ulcerative colitis for decades. The active substance demonstrates a local anti-inflammatory efficacy. However, the treatment opportunities provided by an oral plus rectal administration of mesalazine are not optimally exploited up to now. Particularly in the distal disease, rectal treatment where appropritate in combination with oral administration of mesalazine is indicated in order to ensure optimal therapeutic success. Rectal formulations ensure sufficiently high concentrations of the active substance in the different segments of the colon descendens. Clinical symptoms of ulcerative colitis are mainly the result of inflammatory activity in this section of the colon.The entire colon can be reached with the combination of oral and rectal mesalazine, so that even extensive ulcerative colitis can easily be treated in an anti-inflammatory manner. Clinical trial results confirm that the combined oral and rectal administration of mesalazine shows an increased clinical efficacy in extensive ulcerative colitis. The remission rate was increased and there was a significant clinical improvement after 4 and after 8 weeks of additional rectal administration of mesalazine. Standard therapy of ulcerative colitis with mesalazine can be further optimized. The additional benefit of a combined oral and rectal mesalazine administration is not fully exploited up to now. Patients can benefit from a combined oral and rectal administration of mesalazine. Clinical trial results show an increased remission rate and a significant clinical improvement under this combined treatment.