{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T16:01:13Z","timestamp":1792684873492,"version":"4.5.0"},"reference-count":36,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2022,11,10]],"date-time":"2022-11-10T00:00:00Z","timestamp":1668038400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2022,11,10]],"date-time":"2022-11-10T00:00:00Z","timestamp":1668038400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Digestion"],"published-print":{"date-parts":[[2023]]},"abstract":"<jats:p>Background: Two major types of 5-aminosalicylic acid (5-ASA)-containing preparations, namely, mesalazine\/5-ASA and sulfasalazine (SASP), are currently used as first-line therapy for ulcerative colitis. Recent reports show that optimization of 5-ASA therapy is beneficial for both patient outcomes and healthcare costs. Although 5-ASA and SASP have good efficacy and safety profiles, clinicians occasionally encounter patients who develop 5-ASA intolerance. Summary: The most common symptoms of acute 5-ASA intolerance syndrome are exacerbation of diarrhea, fever, and abdominal pain. Patients who discontinue 5-ASA therapy because of intolerance have a higher risk of adverse clinical outcomes, such as hospital admission, colectomy, need for advanced therapies, and loss of response to anti-tumor necrosis factor (TNF) biologics. When patients develop symptoms of 5-ASA intolerance, the clinician should consider changing the type of 5-ASA preparation. Recent genome-wide association studies and meta-analyses have shown that 5-ASA allergy is associated with certain single-nucleotide polymorphisms. Although there are no modalities or biomarkers for diagnosing 5-ASA intolerance, the drug-induced lymphocyte stimulation test can be used to assist in the diagnosis of acute 5-ASA intolerance syndrome with high specificity and low sensitivity. This review presents a general overview of 5-ASA and SASP in the treatment of inflammatory bowel disease and discusses the latest insights into 5-ASA intolerance. Key Messages: 5-ASA is used as first-line therapy for ulcerative colitis. Optimization of 5-ASA may be beneficial for patient outcomes and healthcare systems. Acute 5-ASA intolerance syndrome is characterized by diarrhea, fever, and abdominal pain. Periodic renal function monitoring is recommended for patients receiving 5-ASA. <\/jats:p>","DOI":"10.1159\/000527452","type":"journal-article","created":{"date-parts":[[2022,11,10]],"date-time":"2022-11-10T22:00:34Z","timestamp":1668117634000},"page":"58-65","source":"Crossref","is-referenced-by-count":85,"title":["Significance of 5-Aminosalicylic Acid Intolerance in the Clinical Management of Ulcerative Colitis"],"prefix":"10.1159","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5104-4415","authenticated-orcid":false,"given":"Yohei","family":"Mikami","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5816-6378","authenticated-orcid":false,"given":"Junya","family":"Tsunoda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6956-2608","authenticated-orcid":false,"given":"Shohei","family":"Suzuki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ichiro","family":"Mizushima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Kiyohara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takanori","family":"Kanai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2022,11,10]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-020-0205-x"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(16)32126-2"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-018-1439-1"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjx009"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2018.12.009"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-021-01784-1"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003715.pub3"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjz180"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2015.03.001"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.15059"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgast-2021-000853"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-200039020-00001"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.15411"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.3892\/br.2021.1472"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1097\/00054725-200108000-00007"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12013"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1097\/mib.0b013e318280b1b8"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.14309\/00000434-201710001-01464"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.5217\/ir.2018.00015"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.15138"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1093\/ibd\/izab004"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2021.01.015"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-79207-z"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.5217\/ir.2019.00084"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1111\/apt.16120"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2004.00547.x"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1016\/j.jim.2021.113036"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1007\/s12328-020-01216-2"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.5217\/ir.2018.16.2.273"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjaa172"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1111\/apt.15408"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1084\/jem.20041948"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1023\/b:pham.0000016246.84974.ec"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1007\/s00281-021-00857-w"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-015-1084-x"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-020-2025-2"}],"container-title":["Digestion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/dig\/article-pdf\/104\/1\/58\/3955111\/000527452.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/karger.com\/dig\/article-pdf\/104\/1\/58\/3955111\/000527452.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T15:27:18Z","timestamp":1745422038000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000527452"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,10]]},"references-count":36,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1,3]]},"published-print":{"date-parts":[[2023,1,12]]}},"URL":"https:\/\/doi.org\/10.1159\/000527452","archive":["Portico"],"relation":{},"ISSN":["0012-2823","1421-9867"],"issn-type":[{"value":"0012-2823","type":"print"},{"value":"1421-9867","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,10]]}}}