口服美沙拉嗪治疗溃疡性结肠炎：药物剂型、疗效预期、剂量反应、依从性及化学预防的进展

Treatment of ulcerative colitis with oral mesalamine: advances in drug formulation, efficacy expectations and dose response, compliance, and chemoprevention.

作者信息

Sandborn William J

机构信息

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.

出版信息

Rev Gastroenterol Disord. 2006 Spring;6(2):97-105.

PMID:16699478

Abstract

Sulfasalazine, olsalazine, balsalazide, delayed-release mesalamine, controlled-release mesalamine, mesalamine pellets, and Multi-Matrix System mesalamine are effective first-line therapies for the treatment of mildly to moderately active ulcerative colitis and for subsequent maintenance of remission. For induction therapy it is unclear if there is a dose response above 1.5 g, and for maintenance therapy existing data do not support a dose response above 1.5 g. Sulfasalazine has more frequent side effects than olsalazine, balsalazide, and mesalamine formulations. Once-daily dosing with multi-matrix system mesalamine 1.2 g tablets may lead to optimal compliance. Mesalamine >/= 1.2 g and sulfasalazine >/= 2 g reduce the risk of colorectal cancer in patients with ulcerative colitis. Drug formulations, efficacy expectations and dose response, toxicity expectations, compliance considerations, and chemoprevention considerations are reviewed.

摘要

柳氮磺胺吡啶、奥沙拉嗪、巴柳氮、缓释美沙拉嗪、控释美沙拉嗪、美沙拉嗪微丸和多基质系统美沙拉嗪是治疗轻至中度活动性溃疡性结肠炎及后续维持缓解的有效一线疗法。对于诱导治疗，尚不清楚剂量超过1.5 g时是否存在剂量反应，而对于维持治疗，现有数据不支持剂量超过1.5 g时的剂量反应。柳氮磺胺吡啶的副作用比奥沙拉嗪、巴柳氮和美沙拉嗪制剂更常见。每日一次服用1.2 g多基质系统美沙拉嗪片可能会达到最佳依从性。美沙拉嗪≥1.2 g和柳氮磺胺吡啶≥2 g可降低溃疡性结肠炎患者患结直肠癌的风险。本文对药物制剂、疗效预期和剂量反应、毒性预期、依从性考量及化学预防考量进行了综述。