Important data in a difficult to treat subpopulation

Implications: Patients with isolated proctitis remain a difficult to treat subpopulation of patients with UC.  Topical mesalamine is often efficacious, but is not always the preferred mode of administration for many patients.  As we have a variety of options as to which oral mesalamine preparation to use in our patients, seeing data on treating proctitis can be useful in making a decision as to which one to use.

Analysis: Treating patients with ulcerative proctitis with oral medications is often challenging, and may be problematic for a variety of reasons, including efficient delivery of the drug to the rectum.  It is often difficult to examine data on proctitis in evaluating efficacy studies when trying to distinguish between the numerous mesalamine preparations on the market.  This study does demonstrate some benefit to using Asacol in patients with proctitis.  It would be useful to have data concerning this from the other mesalamine preparations in which one could compare "apples to apples" and make an informed decision as to which drug to use.  Additionally, from a practical standpoint, one is often more interested in what percentage of patients are able to achieve and/or maintain clinical remission with mesalamine alone, without having to resort to an additional medication.