Review article: balsalazide therapy in ulcerative colitis

Balsalazide is a 5-aminosalicylic acid (mesalazine) prodrug which has an in ert carrier molecule instead of the sulfapyridine moiety of sulfasalazine. It is designed to deliver 5-aminosalicylic acid to the colonic mucosa witho ut the sulfapyridine-associated side-effects encountered with sulfasalazine . Several studies have confirmed the efficacy and patient tolerance of balsal azide. When compared to mesalazine at equivalent doses, it induced symptoma tic and complete remission of acute ulcerative colitis in a greater proport ion of patients. In particular, patients with resistant left-sided disease were shown to have a higher probability of achieving remission. Balsalazide was beneficial in patients with troublesome nocturnal symptoms. It has a s imilar efficacy in maintaining remission when compared to sulfasalazine and mesalazine. The advantage of balsalazide over other 5-aminosalicylic acid compounds is its superior patient tolerability with minimal side-effects.