Abstract
Maintenance of remission is an important consideration in the
medical care of patients with ulcerative colitis. The relapse rate is high when
medications are discontinued. Many types of medications have been investigated
for potential efficacy of maintaining remission. This paper reviews the literature
on maintenance therapy for both distal and universal ulcerative colitis. Sulphasalazine
is the drug of choice since il is effective and relatively low m cost.
5-aminosalicylic acid (5-ASA) derivatives, both oral and rectal forms, are also
effective. Other medications such as metronidazole, cromolyn sodium and prednisone
have nor been shown to be effective maintenance therapy. Strategies for
maintenance are outlined and include possible regimens with 5-ASA enemas.
While 1 g of 5-ASA is effective, the long term relapse rate is similar co that seen
with sulphasalazine. Patients capered co 1 g 5-ASA enemas have a good chance
of maintaining remission if the colitis does not flare within the first few months,
because most colites will flare up early on. Other possible regimens include
intermittent enemas, eg, every other night or every third night. Patients in
remission can be safely maintained in remission with sulphasalazine or one of its
5-ASA derivatives.
Citation
ID:
250411
Ref Key:
miner1990canadianmaintaining