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Liquid mesalamine enemas constitute first-line treatment for left-sided colitis, but some patients have difficulty tolerating and retaining liquid enemas. Foam mesalamine enemas reduce incontinence and improve patient acceptance, but are they as effective as liquid enemas for inducing clinical remission in active left-sided ulcerative colitis?
To find out, researchers performed an international, blinded, noninferiority trial among 375 patients with mild-to-moderate distal ulcerative colitis. Patients were randomized to receive daily doses of mesalamine via foam (1 g of mesalamine per 80 mL of foam) or liquid (1 g of mesalamine per 100 mL of liquid) for 4 weeks. The primary endpoint was clinical remission (defined by a Clinical Activity Index…