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A double-blind comparison of balsalazide, 6.75 g, and sulfasalazine, 3 g, as sole therapy in the management of ulcerative colitis

Lookup NU author(s): Dr John Mansfield


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Background: Sulfasalazine is accepted therapy for active ulcerative colitis, but side-effects and intolerance are common. Balsalazide is an azo-bonded pro-drug which also releases 5-aminosalicylic acid into the colon, but uses an inert carrier molecule. Aim: To compare the safety and efficacy of sulfasalazine, 3 g, with balsalazide, 6.75 g, in the initial daily treatment of mild to moderate ulcerative colitis. Methods: A randomized, multicentre, double-blind, parallel group study was performed, with a treatment duration of 8 weeks. Patients on previous maintenance treatment were excluded. The trial medication was the sole treatment for the colitis. Efficacy was assessed by patient diaries, symptom assessment, sigmoidoscopic appearance and histology. Results: Fifty patients were recruited: 26 allocated to the balsalazide group and 24 to the sulfasalazine group. More patients withdrew due to adverse events in the sulfasalazine group (nine patients vs. one patient in the balsalazide group. P = 0.004). Improvement occurred in both groups, with a tendency to a faster response with balsalazide. Of the patients taking balsalazide, 61% achieved clinical and sigmoidoscopic remission. Conclusions: Balsalazide, 6.75 g, is effective as the sole treatment for patients with mild to moderately active ulcerative colitis, with significantly fewer withdrawals due to side-effects than in a similar group of patients taking sulfasalazine, 3 g.

Publication metadata

Author(s): Mansfield JC; Giaffer MH; Cann PA; McKenna D; Thornton PC; Holdsworth CD

Publication type: Article

Publication status: Published

Journal: Alimentary Pharmacology and Therapeutics

Year: 2002

Volume: 16

Issue: 1

Pages: 69-77

ISSN (print): 0269-2813

ISSN (electronic): 1365-2036

Publisher: Wiley-Blackwell Publishing Ltd.


DOI: 10.1046/j.1365-2036.2002.01151.x


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