Mesalamine for the Treatment of Crohn Disease

Key Messages

• Evidence suggested high-dose mesalamine was more likely to induce remission in patients with mild to moderate active Crohn disease than placebo. There was no significant difference between low-dose mesalamine and placebo for induction of remission.
• Evidence comparing mesalamine to budesonide on remission was mixed. There was some evidence suggesting that high-dose budesonide was more likely to induce remission in patients with mild to moderate active Crohn disease than low-dose mesalamine. However, no significant differences were observed between budesonide and mesalamine at comparable doses (high or low), and when high-dose mesalamine was compared with low-dose budesonide.
• Evidence suggested unspecified corticosteroids were more likely to induce remission in patients with mild to moderate active Crohn disease than mesalamine.
• Evidence suggested there were no differences in withdrawals due to adverse events for mesalamine versus placebo, budesonide, or corticosteroids. Limited evidence suggested there were no significant differences in pancreatitis between patients with active Crohn disease treated with mesalamine versus azathioprine.
• No evidence was identified that evaluated the clinical effectiveness of mesalamine for the treatment of severe active Crohn disease.