Indication

Lialda is indicated for the induction of remission in patients with active, mild to moderate ulcerative colitis (UC) and for the maintenance of remission of UC.

Important Safety Information

  • Lialda is contraindicated in patients with known hypersensitivity to salicylates or aminosalicylates or to any of the ingredients of Lialda.
  • Renal impairment, including minimal change nephropathy, acute and chronic interstitial nephritis, and, rarely, renal failure, has been reported with products such as Lialda that contain mesalamine or are converted to mesalamine. It is recommended that patients have an evaluation of renal function prior to initiating use of Lialda and periodically while on therapy. Exercise caution when using Lialda in patients with known renal dysfunction or a history of renal disease.

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For active, mild to moderate ulcerative colitis (UC)

Important Safety Information

Lialda is contraindicated in patients with known hypersensitivity to salicylates or aminosalicylates or to any of the ingredients of Lialda. See Important Safety Information

Lialda® (mesalamine): #1 Prescribed 5-ASA Among Gastroenterologists1

Information About Ulcerative Colitis

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Ulcerative Colitis Characteristics

Ulcerative colitis (UC) is a chronic disease characterized by diffuse mucosal inflammation of the colon. UC usually involves the rectum and may extend to the large intestine to varying degrees.1,2

  • Proctitis – inflammation is limited to the rectum.1,3
  • Proctosigmoiditis/left-sided colitis – inflammation in the rectum and sigmoid colon that may extend up to the splenic flexure.1,3
  • Pancolitis/extensive colitis – inflammation extends into the transverse colon and may include the ascending colon.1,3

The extent of involvement does not always correspond to the severity of disease, but it does impact prognosis and influence treatment choice.1,3

Levels of Severity of Ulcerative Colitis Symptoms

Disease severity may be classified as2:

  • Mild – less than 4 stools daily, with or without blood, no systemic signs of toxicity, and a normal erythrocyte sedimentation rate (ESR)
  • Moderate – more than 4 stools daily but with minimal signs of toxicity
  • Severe – more than 6 bloody stools daily, and evidence of toxicity as shown by fever, tachycardia, anemia, or an elevated ESR
  • Fulminant – may have more than 10 bowel movements daily, continuous bleeding, toxicity, abdominal tenderness and distension; may require blood transfusion and colonic dilation on abdominal plain films

The clinical course of UC is marked by exacerbations (flares) and remissions, which may occur spontaneously or in response to changes in treatment or intercurrent illnesses.2

Presenting symptoms of UC are typically insidious rather than abrupt. Classic ulcerative colitis symptoms include1,4:

  • Intermittent bloody diarrhea
  • Rectal urgency
  • Tenesmus

Other symptoms may include1:

  • Constipation with interim passage of blood or mucus
  • Abdominal pain or cramps preceding bowel movements

Ulcerative Colitis Diagnosis

Physical Exam and History

A differential diagnosis should rule out infectious colitis, Crohn’s disease, and irritable bowel syndrome (IBS).1,4,5 A thorough clinical history can provide clues on the etiologies of symptoms experienced in patients not previously diagnosed with UC. For example, abdominal pain that is relieved by a bowel movement may be an indicator of IBS rather than UC.4

A thorough physical exam should be conducted with every patient, keeping in mind that extraintestinal findings may be present in patients with UC.4

Diagnostic Testing

Laboratory tests may include2,4:

  • Stool examination for ova and parasites
  • Stool culture
  • Testing for Clostridium difficile toxin
  • Erythrocyte sedimentation rate
  • C-reactive protein
  • Complete blood count
  • Basic metabolic profile

Sigmoidoscopy or colonoscopy and biopsy2,4:

These tests are common for diagnosing UC. They can detect such characteristic changes as:

  • Loss of typical vascular pattern
  • Friability
  • Exudates
  • Ulcerations
  • Granularity

Ulcerative Colitis Treatment Options

Although there are no medications that cure UC, there are effective treatment options for managing symptoms.2,3,6 According to the American College of Gastroenterology (ACG) guidelines, inducing and maintaining remission of symptoms are both goals of UC treatment.2

5-ASAs are an ACG-recommended first-line therapy option for appropriate patients with active, mild to moderate UC.2 Additional treatment options for other severities of UC include2:

  • Corticosteroids
  • Immunosuppressants
  • Biologic therapies
  • Surgery

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