Crohn's Disease: The Complete Guide to Medical Management

Gary R. Lichtenstein, MD, FACP, FACG, AGAF

Chapter 10: Mesalamine for Maintenance Therapy in Ulcerative Colitis: How Much, How Long? (continued)

Miles P. Sparrow, Md, MBBS, FRACP; Wee-Chian Lim, MD, MBBS, MMed, MRCP; Stephen B. Hannauer, MD

Sulfasalazine, the prototype aminosalicylate that combines sulfapyridine (an antibiotic) with the anti-inflammatory 5-ASA, was found to be efficacious for UC in the 1940s. It was not until the 1970s that 5-ASA was recognized as the active moiety, with the sulfapyridine component acting as an inert carrier molecule that delivers the 5-ASA to the site of active mucosal inflammation in the colon only.2 This discovery and the recognition that the “sulfa” component was responsible for most of the allergic and dose-dependent side effects of sulfasalazine led to the development of…