MMX mesalamine: a novel high-dose, once-daily 5-aminosalicylate formulation for the treatment of ulcerative colitis.

BACKGROUND: 5-Aminosalicylate (5-ASA) agents are the first-line therapy for ulcerative colitis (UC). A high-dose, once-daily formulation of 5-ASA known as MMX mesalamine has recently been approved for the treatment of UC. OBJECTIVE: To summarize current data on MMX mesalamine and to discuss its impact on management of UC. METHODS: A systematic review of published literature was performed on PubMed using the search terms 'MMX mesalamine' and 'Lialda'. Abstracts presented at US gastroenterology conferences between 2006 and 2007, were also reviewed. RESULTS: MMX mesalamine uses a novel multi-matrix delivery system to achieve a sustained release of 5-ASA throughout the colon. Clinical trials have demonstrated MMX mesalamine 2.4 g/day or 4.8 g/day to be superior to placebo in inducing remission in active mild to moderate UC. The drug is well tolerated with a safety profile comparable to other oral 5-ASA agents. With a high-dose formulation of 1.2 g 5-ASA per tablet, MMX mesalamine can be administered conveniently at two to four pills once a day. CONCLUSION: MMX mesalamine is the first and only approved once-daily 5-ASA treatment option for patients with UC. It is efficacious for the induction of remission in mild to moderate UC and has a favorable safety profile. With the advantage of low pill burden and easy dosing schedule, it may potentially improve patient compliance and treatment success.