Mesalamine Is Ineffective in Collagenous Colitis

The goal of treatment in collagenous colitis is relief from diarrhea. Nonspecific therapies including loperamide, diphenoxylate, cholestyramine, and bismuth are useful, and anti-inflammatory drugs are often used, including systemic corticosteroids, budesonide, 5-aminosalicylates and, in challenging cases, even immunomodulators and agents such as cyclosporine. Of these, evidence of efficacy is strongest for budesonide.

Now, investigators have assessed the efficacy and tolerability of mesalamine in comparison with budesonide. They randomized 92 patients with active collagenous colitis to budesonide (9 mg) once daily, mesalamine (3 mg) once daily, or placebo for 8 weeks using a double-blind, double-dummy study design.

Patients who received budes…