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Corticosteroids are effective at inducing remission in patients with ulcerative colitis (UC); however, it is not known if adding mesalamine confers additional benefits in the acute setting.

In a recent global randomized controlled study published in , patients hospitalized for acute severe UC were randomized to corticosteroids alone or corticosteroids with mesalamine. The primary outcome was the proportion of patients with a response to treatment after 7 days, as measured by an improvement in the Lichtiger score by at least 4 points, with an absolute score <10. Of the 149 included patients, 25% failed treatment by 7 days. There were no differences in the primary endpoint or key secondary endpoints, including length of hospital stay, rate of colectomy, or need for salvage therapy, for patients receiving corticosteroids alone versus with mesalamine.

Clinically, this study suggests that the addition or continuation of mesalamine with corticosteroids was of no benefit to hospitalized patients with acute severe UC.

Michelle Long, MD, is an assistant professor of medicine in the department of medicine, section of gastroenterology, at Boston University School of Medicine in Boston, Massachusetts.

You can read an interview with the lead study author here, and the abstract of the study here.