INNOVATIONS IN TOPICAL THERAPY

Topical therapy can be considered the standard treatment for distal ul cerative colitis. The group of drugs of first choice are the aminosali cylates which are effective in inducing remission in acute disease as well as in preventing relapse. Corticosteroids appear to be slightly l ess effective and have no proven benefit in maintenance therapy. With new topical steroids, such as budesonide, systemic effects can be mini mized. The major role of corticosteroids is to complement aminosalicyl ates, when necessary. The new topical compounds appear to be especiall y valuable when there is a long-term requirement for corticosteroids. With the vast majority of patients obtaining remission with standard t reatment, it is difficult to make the case for alternative substances. Short-chain fatty acids, local anaesthetics and bismuth compounds see m to be the most promising innovations in topical therapy although the ir equivalence or even superiority to mesalazine has not been establis hed.