Ulcerative colitis:
newer 5-ASA formulations seem to have similar efficacy to the older sulfasalazine for the treatment of acute UC;
high doses of 5-ASA seem to achieve better results in the acute treatment of UC, although the exact dosage schedule with each 5-ASA formulation remains unknown;
the disease location of UC does not seem to affect the response to therapy;
the efficacy of different 5-ASA formulations in UC is unclear;
5-ASA and sulfasalazine seem to have similar efficacy in the long-term (at least 12 months) maintenance of remission of UC, and therefore, the choice between the two drugs would depend on factors such as cost or safety, rather than effectiveness;
the benefits of using high-doses of 5-ASA are still unclear;
there are currently insufficient data to conclude whether one 5-ASA formulation is better than another to maintain remission of UC;
topical 5-ASA (as suppositories, foam or liquid enema) are at least as effective, and probably more effective, than topical steroids for the treatment of distal UC;
a 1 g 5-ASA enema seems to be sufficient for patients with mild to moderately active distal UC; and
topical 5-ASA formulations are effective for both the treatment of acute UC and for the maintenance of remission.
Crohn's disease:
when prescribing 5-ASA formulations for the acute-phase treatment of CD, high doses of these drugs should be used;
some studies suggest that, for the treatment of acute CD, different 5-ASA formulations may be chosen depending on the location of the disease;
the risk of clinical recurrence may be significantly reduced by 5-ASA maintenance treatment in patients with surgically induced remission;
the length of previous remission of CD does not seem to be useful in clinical practice for predicting the response to 5-ASA for the maintenance of remission in a particular patient; and
adverse events after prolonged-release mesalamine do not appear to be dose-related, the use of higher dosages seems to be reasonable in maintenance treatment.