Which medication is most commonly used for maintenance therapy in ulcerative colitis?

Oral mesalamine is the most commonly used medication for maintenance therapy in ulcerative colitis due to its anti-inflammatory properties that target the colonic mucosa. Mesalamine, a 5-aminosalicylic acid (5-ASA) compound, works topically on the colonic mucosa to reduce inflammation, and its use is supported by numerous studies demonstrating its effectiveness in maintaining remission in patients with ulcerative colitis.

The advantages of oral mesalamine include a favorable side effect profile and convenience in administration, allowing for long-term use without significant risks associated with immunosuppressive therapy. It is often the first-line option in patients who achieve remission following an acute flare, as it helps prevent relapses.

In contrast, corticosteroids are typically employed for short-term treatment of acute exacerbations due to their potency in rapidly controlling inflammation but are not ideal for maintenance due to potential long-term side effects. Azathioprine is an immunosuppressant that may be used for maintenance but is usually reserved for patients who do not respond to mesalamine or have more severe disease as it carries a higher risk of adverse effects. Infliximab is a monoclonal antibody used for moderate to severe cases and is more commonly utilized