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Pediatric Inflammatory Bowel Disease pp 317–324Cite as

5-Aminosalicylate Therapy

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Abstract

Aminosalicylates are a class of medications commonly used as first-line therapy for induction and maintenance of remission in mild to moderate inflammatory bowel disease (IBD) [1]. Although their use in ulcerative colitis (UC) is well established, their role in Crohn’s disease (CD) remains controversial. Aminosalicylates were derived from sulfasalazine (SASP), comprised by two moieties with antimicrobial and anti-inflammatory properties, sulfapyridine and 5-aminosalicylic acid (5-ASA), respectively [2, 3]. In the colonic lumen, bacteria metabolize the azo bond that joins the subunits thereby releasing the therapeutically active 5-ASA and the inactive sulfapyridine [4]. Although effective for the treatment of IBD, the dose-related adverse effects and hypersensitivity reactions associated with sulfapyridine led to the development nonsulfa aminosalicylates. The use of 5-ASAs in adults with IBD is well established; however, there is limited evidence for their safety and efficacy in the pediatric IBD population. This shortcoming is further accentuated by mounting evidence that suggests important differences between adult and pediatric IBD. Nonetheless, 5-ASAs are commonly used in pediatric IBD patients and their use in this population remains mainly guided by the adult literature.

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Authors and Affiliations

  1. Division of Pediatric Gastroenterology and Hepatology, Mayo Clinic Children’s Center, 200 First Street SW, Rochester, MN, 55905, USA

    Michael Stephens MD & Michelle Gonzalez MD

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  1. Michael Stephens MD
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  2. Michelle Gonzalez MD
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Correspondence to Michael Stephens MD .

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Editors and Affiliations

  1. Division of GI, Hepatology & Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA

    Petar Mamula

  2. Division of GI, Hepatology & Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA

    Andrew B. Grossman

  3. Division of GI, Hepatology & Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA

    Robert N. Baldassano

  4. Division of GI, Hepatology & Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA

    Judith R. Kelsen

  5. Division of Pediatric Gastroenterology & Nutrition, University of South Carolina School of Medicine - Greenville, Greenville, South Carolina, USA

    Jonathan E. Markowitz

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Stephens, M., Gonzalez, M. (2017). 5-Aminosalicylate Therapy. In: Mamula, P., Grossman, A., Baldassano, R., Kelsen, J., Markowitz, J. (eds) Pediatric Inflammatory Bowel Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-49215-5_25

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  • DOI: https://doi.org/10.1007/978-3-319-49215-5_25

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