Balsalzide – a new promising treatment for ulcerative colitis

A study published in the January 1998 volume of Gastroenterology has found that balsalazide is not only better at treating ulcerative colitis (a type of inflammatory bowel disease) than the established therapy mesalamine but that it is also better tolerated by patients. Patients receiving balsalazide during the trial experienced more rapid and complete symptomatic relief and greater reductions in disease activity, regardless of the underlying disease severity. Balsalazide therefore may be a new, reliable treatment that can reduce the burden of disease from ulcerative colitis in the community.

For many years doctors and researchers have tried to identify suitable treatments to reduce the severity of disease and symptoms in patients with ulcerative colitis. Ulcerative colitis along with Crohn’s disease fits into the class of diseases known as ‘inflammatory bowel disease’ and is characterised by extensive inflammation and ulceration of the lining of the large intestine. Ulcerative colitis is a chronic (long-lasting) disorder that commonly affects young patients aged 15-40. It produces nasty, recurrent attacks of diarrhoea (streaked with blood and mucus), abdominal pain and the sudden urge to defaecate. In addition, ulcerative colitis can increase the risk of colon cancer so it is important that there are reliable treatments available. Most patients will be treated with a combination of drugs, usually an aminosalicylate and a local steroid during acute attacks. The current study conducted in the United Kingdom looked at the effects of two particular drugs, namely balsalazide and delayed-release mesalamine, for the treatment of acute ulcerative colitis. Both drugs contain the same active component which reduces inflammation in the bowel wall; however the formulations of the drugs differ. In particular, balsalazide has an additional compound added to the active group which ensures it is not activated until it reaches the colon (the active site of disease). Approximately 100 patients with ulcerative colitis were included in the study and they were randomly allocated to receive one of the two drugs. After follow-up at 4,8 and 12 weeks it was found that patients taking balsalazide had greater relief of symptoms, less side effects and greater improvement of disease on imaging studies. This suggests that balsalazide is a better treatment for ulcerative colitis than the previously widely used mesalamine. This study can therefore help doctors decide which treatment is the most suitable to treat patients with ulcerative colitis. The study revealed the benefits of a relatively new drug formulation that overcomes some of the problems of poor symptomatic relief and excessive side effects found with previous drugs used for this disease. Balsalazide may therefore become one of the main treatments for ulcerative colitis and help to reduce the burden of this disease. If you suffer from ulcerative colitis you should discuss your treatment options fully with your doctor. They will then decide if this medication is suitable for you based on your disease severity, allergies and numerous other factors. (Source: Green J, Lobo A, Holdsworth C, Leicester R, Gibson J, Kerr G, Hodgson H, Parkins K, Taylor M & The Abacus Investigator Group, Balsalazide is More Effective and Better Tolerated Than Mesalamine in the Treatment of Acute Ulcerative Colitis, Gastroenterolgy 1998; 114: 15-22.)