"Pentasa is useless for Crohn's" -- then why is it so prescribed?

Pentasa is used a lot in UC so sometimes if the Crohn’s medication isn’t working then they’ll try something like pentasa to see if it is maybe UC instead. That’s usually only if it is in the colon though. They do the same for UC people as well... even though the medications for UC and Crohn’s are basically the same, they work differently sometimes. This is just based off of what I’ve heard though so it could be wrong!

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Diagnosed at 7, in the gray area between crohns and UC. Surgery on Jan 27, 2018 #nocolonstillrollin

Pentasa is a topical medication that effectively treats shallow-inflammation involving the top-most layers of intestinal tissue. UC is shallow-inflammation involving the top most layers of intestinal tissue, a good match for it, and used widely for UC patients. Crohn's is deep-inflammation that often goes much, much further into the intestinal tissue and therefore Pentasa might only partially treat it. I would hope that when prescribing pentasa to Crohn's patients that doctors are choosing those patients with the mildest cases who present shallower-inflammation rather than those with more severe inflammation that goes deeper. Biopsy results would identify the depth of inflammation, so it would be a known factor to your gasteroenteroligist at the time he/she prescribes you medication to treat your Crohn's. Maybe selective usage with Crohn's has an affect for mild cases? It at least seems plausible. I'll defer to those who know more and have Crohn's themselves on that point (I have UC).

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Moderator Ulcerative Colitis
John, 39, UC Proctosigmoiditis
Rx: Remicade @5mgs/kg/6wks; daily 75mgs 6MP, 4.8g generic-Lialda, and rowasa
UC experience: wakeup with noisy bowels so no lingering in bed, soon after poop with discomfort/pain/mild-nausea, eat something, poop, get dressed, poop, leave in car and worry whole drive about more...

From my Dr’s perspective, he said insurance companies want proof that other drugs have been tried & failed prior to authorizing treatment/payment for biologics. And along those lines, since everyone responds to meds differently, it makes sense to start with lower risk drugs on the off chance it may be effective for you?

Good luck to you, and all.