MMX® Mesalazine: a review of its use in the management of mild to moderate ulcerative colitis.

The Multi MatriX system (MMX®) formulation of mesalazine (Lialda®; Mesavancol®; Mezavant®) [henceforth referred to as MMX mesalazine] is an oral, high-dose, once-daily, gastro-resistant, prolonged-release formulation indicated for use in patients with mild to moderate ulcerative colitis. Mesalazine has numerous anti-inflammatory effects on the mucosa of the colon, parts of which are frequently inflamed in ulcerative colitis. MMX mesalazine is believed to act topically. Therapy with MMX mesalazine 2.4 or 4.8 g once daily for 8 weeks was superior to placebo in inducing clinical and endoscopic remission in patients with mild to moderate ulcerative colitis. In 12-month maintenance trials, MMX mesalazine 2.4 g/day maintained remission in about two-thirds of patients and was as effective as Asacol® 2.4 g/day (another oral formulation of mesalazine) as maintenance therapy. In general, MMX mesalazine was well tolerated in both short- and long-term clinical trials; its tolerability profile did not differ clinically to that of placebo or Asacol®. The majority of adverse events reported in clinical trials were gastrointestinal in nature. Therefore, MMX mesalazine appears to be a valuable option in the management of patients with mild to moderate ulcerative colitis.