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Mesalazine adherence — GPhC CRA MCQ

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HardGastrointestinal TherapeuticsMesalazine adherenceGPhC CRA

A 48-year-old with left-sided ulcerative colitis achieved remission after a mild flare using oral and topical mesalazine. He has been well for three months, renal function is stable and he wants to stop all treatment. Which maintenance strategy best reflects NICE guidance?

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Correct answer: D — Continue an oral aminosalicylate at an agreed maintenance dose

For adults with left-sided or extensive ulcerative colitis in remission after a mild-to-moderate flare, NICE recommends a low maintenance dose of an oral aminosalicylate. The exact regimen is agreed with the IBD team, taking account of preference, adverse effects and monitoring. Continuous systemic corticosteroids are unsuitable for maintenance, and waiting for bleeding to recur forfeits relapse prevention.

Reference: NICE NG130, Ulcerative colitis: https://www.nice.org.uk/guidance/ng130/chapter/recommendations