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Mesalazine + prednisolone is a combination therapy used primarily for the treatment of inflammatory bowel diseases (IBD), including ulcerative colitis and Crohn's disease. Mesalazine (5-aminosalicylic acid) is a salicylate derivative that exerts local anti-inflammatory effects on the colonic mucosa, likely through the activation of peroxisome proliferator-activated receptor gamma (PPAR-γ) and the inhibition of cyclooxygenase (COX) and lipoxygenase (LOX) enzymes. Prednisolone is a synthetic glucocorticoid that provides potent systemic anti-inflammatory and immunosuppressive effects by acting as an agonist at the glucocorticoid receptor, leading to the modulation of gene expression and the reduction of pro-inflammatory cytokine production. This combination is frequently employed to induce remission in patients with active IBD who require more intensive therapy than 5-ASA monotherapy.
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