Bergman R, Parkes M
Department of Gastroenterology, Addenbrooke's Hospital, Cambridge, UK.
Aliment Pharmacol Ther. 2006 Apr 1;23(7):841-55. doi: 10.1111/j.1365-2036.2006.02846.x.
Mesalazine is among the medications most commonly prescribed by gastroenterologists, having to a large extent superseded sulfasalazine (sulphasalazine). However, there are still a number of aspects regarding its use which provoke debate and controversy.
To provide a systematic assessment of the evidence for the use of mesalazine in ulcerative colitis and Crohn's disease.
References were identified using PubMed database. Additional references were identified with related article searches.
Mesalazine has a clear role in the maintenance of remission in ulcerative colitis and management of mild to moderately active disease, although the efficacy of topical preparations or combined topical and oral is clearly superior to oral alone. Evidence that increasing the dose of oral mesalazine improves efficacy is not clear-cut. The benefits of mesalazine in the management of acute Crohn's disease and the maintenance of remission are questionable and alternative treatments are usually more appropriate. Emerging evidence suggests that maintenance mesalazine reduces the risk of neoplastic progression in chronic ulcerative colitis. Compliance with therapy is thus important, as is an understanding of individuals most likely to default on this.
Evidence for a beneficial effect of mesalazine is largely confined to the management of ulcerative colitis.
美沙拉嗪是胃肠病学家最常处方的药物之一，在很大程度上已取代柳氮磺胺吡啶。然而，关于其使用仍有许多方面引发了争论和争议。
对美沙拉嗪在溃疡性结肠炎和克罗恩病中的使用证据进行系统评估。
通过PubMed数据库识别参考文献。通过相关文章搜索识别其他参考文献。
美沙拉嗪在溃疡性结肠炎缓解期的维持以及轻度至中度活动性疾病的管理中具有明确作用，尽管局部制剂或局部与口服联合使用的疗效明显优于单纯口服。口服美沙拉嗪增加剂量是否能提高疗效的证据并不明确。美沙拉嗪在急性克罗恩病管理和缓解期维持中的益处值得怀疑，通常更适合采用替代治疗。新出现的证据表明，维持使用美沙拉嗪可降低慢性溃疡性结肠炎肿瘤进展的风险。因此，治疗依从性很重要，了解最有可能不遵守治疗的个体也很重要。
美沙拉嗪有益效果的证据主要局限于溃疡性结肠炎的管理。
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