Abstract：
Medical therapy is the cornerstone of ulcerative colitis (UC) management and aims to induce and maintain remission. In case of mild-to-moderate UC, mesalamine (5-ASA) is the first-line option. 5-ASA requires local release at the level of the inflamed mucosa to exert its therapeutic action. While rectal preparations are useful in distal colitis, in cases of UC of at least rectosigmoid extent, guidelines suggest the association of oral and rectal 5-ASA. Mesalamine with Multi Matrix System® technology (MMX mesalamine) is an oral, high-strength (1.2 g/tablet), once-daily formulation of 5-ASA, designed to provide delayed and prolonged release throughout the entire colon. Clinical trials demonstrated a strong efficacy in inducing and maintaining clinical and endoscopic remission in active mild-to-moderate UC. The efficacy is related to specific colonic drug-delivery, to its high-dosage and once-daily administration, thus improving patients\' adherence and outcomes. The specific colonic-delivery is also associated with very low rates of systemic absorption and adverse events (AEs). With this comprehensive review we aimed to summarize current knowledge on MMX mesalamine in mild-to-moderate UC, in terms of clinical pharmacology, efficacy and safety, also compared to other 5-ASA products. In addition we provided an expert opinion on the topic, examining the implications on clinical practice.
摘要：
药物治疗是溃疡性结肠炎（UC）管理的基石，旨在诱导和维持缓解。在轻度至中度UC的情况下，美沙拉嗪（5-ASA）是一线选择。5-ASA需要在发炎的粘膜水平上局部释放以发挥其治疗作用。虽然直肠制剂可用于远端结肠炎，在至少直肠乙状结肠程度的UC的情况下，指南建议口服和直肠5-ASA的相关性。采用MultiMatrixSystem®技术的美沙拉嗪（MMX美沙拉嗪）是一种口服，高强度（1.2克/片），每日一次的5-ASA配方，旨在在整个结肠中提供延迟和延长的释放。临床试验表明，在活动性轻度至中度UC中，在诱导和维持临床和内窥镜缓解方面具有很强的疗效。疗效与特定的结肠药物递送有关，高剂量和每日一次给药，从而提高患者的依从性和预后。特定的结肠递送还与非常低的全身吸收和不良事件(AE)的比率相关。通过这篇全面的综述，我们旨在总结MMX美沙拉嗪在轻度至中度UC中的最新知识，在临床药理学方面，功效和安全性，与其他5-ASA产品相比。此外，我们提供了有关该主题的专家意见，检查对临床实践的影响。
