Non-steroid anti-inflammatory drugs (NSAID) have been used for over 50 years in the treatment of Crohn's disease and still are the mainstream of the conservative treatment. Sulphasalazine is a combination of 5-aminosalicylic acid (5-ASA) and sulfapyridine. 5-ASA has strong anti-inflammatory properties; it decreases synthesis of inflammatory mediators including leukotriens (LT4), prostaglandins and PAF. Sul-phasalazine is indicated for mild to moderate forms of CD and also in cases with large-bowel involvement. Active inflammatory changes in the small bowel and right colon respond better to mesalazine, which is characterised by the delayed release of the active drug right in the small intestine. National Cooperative Crohn's Disease Study (1979) showed the effectiveness of sulphasalazine in doses of 1 g/15 kg/day in patients with a colonic type of the disease. Regression of symptoms was observed in 38% of patients, while in the placebo group this was only true for 20% . The effectiveness of 5-ASA in the treatment of active CD was further documented in the nineties with a dose of >4.5 g/day and sustaining remission, with a dose of >2.0 g/day . One of the side effects of the sulphasalazine treatment is impaired absorption of the folic acid; therefore, its supplementation is indicated during the therapy. Mesalazine has less, and milder side effects.
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