Aminosalicylates for treatment of active Crohn's disease

Crohn's disease is a chronic inflammatory disease of the intestines. Although Crohn's disease is often found in the ileum (the lower part of the small intestine), it can occur in any part of the digestive tract, from the mouth to the anus. The most common symptoms of Crohn's disease are diarrhea and abdominal pain which often occurs in the lower right region of the abdomen. Aminosalicylates are thought to treat Crohn's disease by reducing the inflammation of the intestines caused by the disease. Nineteen studies were reviewed. The studies compared aminosalicylates (sulfasalazine, mesalazine and mesalamine) with placebo (inactive pills or tablets) corticosteroids or budesonide (a steroid that is rapidly metabolized by the body and has less side-effects than traditional corticosteroids) and found that sulfasalazine provides a modest benefit for the treatment of mild to moderately active Crohn's disease compared to placebo and is inferior to corticosteroids for treatment of active Crohn's disease. Sulphasalazine differs from other aminosalicylates in that it contains a sulpha portion that has been eliminated in the other preparations. Mesalazine and mesalamine formulations are not effective for inducing remission in active Crohn's disease. Budesonide was compared with high dose mesalamine (3 to 4.5 g/day) and was more effective for inducing remission. Aminosalicylates are safe for patients with Crohn's disease. Side effects are generally mild in nature and typically include nausea, vomiting, diarrhea, abdominal pain and dyspepsia (upset stomach or indigestion). In conclusion, sulfasalazine is modestly effective for the treatment of active Crohn's disease. However, the existing data show little benefit for mesalamine.