Posted 5/18/2014 7:50 PM (GMT -6)
Hi, somebody on this forum recently,and very kindly posted the following, I forgot who, but I think it will give you a better understanding of the drugs used to treat UC...the 5 ASA drugs mentioned contain Mesalamine which is what we were referring to....I take Pentasa, one of the 5 ASA drugs that contains Mesalamine.
5-ASAs are really the first line treatment for UC and are relatively weak drugs.
Since you are new to UC Ill give you a super quick run down of the main drugs we use so that you can be informed when you talk to your GI next:
1) 5-ASA: There are a bunch of different brands/types of 5-ASA drugs (mezavant, salofalk, etc) however they all contain the same active ingredient (namely, 5-ASA) and thus you can consider them to be the same drug. This compound works topically on the epithelial cells of the colon to reduce inflammation locally. I believe most UC patients take this drug in some capacity.
2) Immunomodulators: The main drugs in this category are azathioprine and mercaptopurine. They work by suppressing the production of B and T cells, which are the main cells that contribute to inflammation. These are pretty serious drugs that are often used in chemotherapy since they attack rapidly proliferating cells (in this case, the B and T cells). They can also have a lot of rare, but serious side effects (including cancers) so they should not be taken lightly. A very common azathioprine drug is called imuran. I suspect this is the drug your GI wants you to get next.
3) Corticosteroids: This mainly includes prednisone, prednisolone, and budesonide/Uceris. These drugs are infamous for their long list of scary side effects, however, their efficacy is tremendous. They can induce remission in as little as 24-48 hours. However, due to the risks, they are mostly used as short term solutions to induce immediate remission, and typically are not used long term (i.e. more than 2 months at a time). Budesonide/Uceris is a newer drug that is very similar to prednisone, but is more specific for the colon and therefore safer, so if you are from the States, you may want to try it as an alternative to prednisone.
4) Biologics: The main biologic drugs we have are TNF antibodies. These drugs bind to TNF (a pro-inflammatory cyctokine) and prevent it from inducing inflammation. Because they are antibodies they are 1) extremely expensive, and 2) have to taken either intravenously or by injection. However, they do have great efficacy for many people and can be taken long term. The main drugs in this category are Remicade (infliximab) and Humira (adalimumab). This is generally considered the last line of conventional treatment.
Thats really it in terms of the conventional treatments available right now, but there are a lot of great drugs that will be coming out in the next few years (vedolizumab, tofacitinib, etc). Additionally, there are a lot of other "non-conventional" treatments to considered as well (eg. fecal biotherapy, wild oil of oregano, probiotics, etc).