Olsalazine sodium (Dipentum - Pharmacia), a dimer (two molecules linked by an azo bond) of 5-aminosalicylic acid, was recently approved by the US Food and Drug Administration for oral use to maintain remission of ulcerative colitis in adult patients who cannot tolerate sulfasalazine (Azulfidine; and others).

An oral formulation of mesalamine (5-aminosalicylic acid, 5-ASA, Asacol - Proctor & Gamble), was recently approved by the US Food and Drug Administration (FDA) for treatment of mildly to moderately active ulcerative colitis; it has not been approved for maintenance of remissions. Olsalazine (Dipentum), a similar drug (Medical Letter, 32:105, 1990), is approved for maintenance of remissions but not for treatment.

Mesalamine (Rowasa - Reid-Rowell), probably better known as 5-aminosalicylic acid (5-ASA) and also called mesalazine in some other countries, was recently marketed in the USA as an enema for treatment of mild to moderate distal ulcerative colitis, including ulcerative proctosigmoiditis and ulcerative proctitis.

View Expanded Table: Some Conventional DMARDs for Rheumatoid Arthritis

View the Table: Safety of Drugs for IBD in Pregnancy

View the Flowchart: Rheumatoid Arthritis Treatment

Rheumatoid arthritis (RA) is prevalent in 0.5% of adults in the US; it is about 2.5 times more common in women than in men. Guidelines for treatment of RA from the American College of Rheumatology were recently updated. The goal of treatment is to minimize disease activity and prevent irreversible joint damage.

Balsalazide disodium (Colazal), a prodrug of mesalamine, was marketed in the US this year for oral treatment of mildly to moderately active ulcerative colitis. Oral formulations of mesalamine have been available in the US for nine years for treatment and maintenance of remissions and olsalazine, which is a dimer of mesalamine, is marketed for maintenance of remissions but not for treatment. Balsalazide has been available in Europe for four years.

View the Table: Some Drug Interactions with Drugs for IBD

Psoriatic arthritis is a chronic inflammatory arthropathy associated with psoriasis. A recent review found that about 20% of patients with psoriasis have psoriatic arthritis. Updated guidelines for treatment of psoriatic arthritis have recently been published.