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Mesalamine in pediatric inflammatory bowel disease: a 10-year experience

I D Dʼagata1, T Vanounou, E Seidman

  • 1Division of Gastroenterology-Nutrition, Department of Pediatrics, Ste-Justine Hospital, University of Montreal, Montreal, Quebec, Canada.

Inflammatory Bowel Diseases
|January 4, 2013
PubMed

Insights

Mesalamine is a safe and well-tolerated medication for pediatric patients with inflammatory bowel disease, including ulcerative colitis and Crohn's disease. Long-term use showed minimal side effects, supporting its efficacy in children and adolescents.

Area of Science:

  • Pediatric Gastroenterology
  • Pharmacology
  • Inflammatory Bowel Disease (IBD)

Background:

  • Mesalamine (5-aminosalicylic acid) is an established treatment for ulcerative colitis and Crohn's disease.
  • Limited data exist on mesalamine's use, safety, and optimal dosing in pediatric populations.

Purpose of the Study:

  • To evaluate the usage patterns, safety profile, and optimal dosage of mesalamine in pediatric patients with IBD.
  • To assess mesalamine's effectiveness in treating active disease and preventing relapse in children and adolescents.

Main Methods:

  • Retrospective chart review of 153 pediatric patients with IBD treated with mesalamine.
  • Analysis of patient demographics, disease characteristics (ulcerative colitis vs. Crohn's disease), treatment duration, dosage, and adverse events.
  • Data collected over >150 patient-years of mesalamine use.

Main Results:

  • Mesalamine was used for both ulcerative colitis (33 patients) and Crohn's disease (120 patients), with varying disease involvement.
  • Average doses for active disease and maintenance therapy were similar (36 mg/kg/day) when used as monotherapy, increasing to 43 mg/kg/day since 1992.
  • Only 5.2% of patients experienced objective side effects, with diarrhea exacerbation being most common. No serious adverse reactions were reported.

Conclusions:

  • Mesalamine is a safe and well-tolerated option for the long-term management of pediatric ulcerative colitis and Crohn's disease.
  • The study supports the continued use of mesalamine in pediatric IBD patients, highlighting its favorable safety profile.
  • Further research may refine optimal dosing strategies for specific pediatric IBD subtypes.

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