New developments in ulcerative colitis: latest evidence on management, treatment, and maintenance

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Abstract

Ulcerative colitis (UC) is a chronic idiopathic inflammatory disorder that involves any part of the colon starting in the rectum in a continuous fashion presenting typically with symptoms such as bloody diarrhea, abdominal pain, and rectal urgency. UC is diagnosed based on clinical presentation and endoscopic evidence of inflammation in the colon starting in the rectum and extending proximally in the colon. The clinical presentation of the disease usually dictates the choice of pharmacologic therapy, where the goal is to first induce remission and then maintain a corticosteroid-free remission. There are multiple classes of drugs that are available and are used based on the clinical severity of the disease. For mild-to-moderate disease, oral or rectal formulations of 5-aminosalicylic acid are used. In moderate-to-severe UC, corticosteroids are usually used in induction of remission with or without another class of medications such as thiopurines or biologics including anti-tumor necrosis factor, anti-integrins, or Janus kinase inhibitors for maintenance of remission. Up to 15% of the patients may require surgery as they fail to respond to medications and have risk of developing dysplasia secondary to longstanding colitis.

Keywords: colitis, inflammatory bowel disease, ulcerative colitis.

Citation: Tripathi K, Feuerstein JD. New developments in ulcerative colitis: latest evidence on management, treatment, and maintenance. Drugs in Context 2019; 8: 212572. DOI: 10.7573/dic.212572

Contributions: Both authors contributed equally to the preparation of this review. The authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Disclosure and potential conflicts of interest: The authors declare that they have no conflicts of interest. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors are available for download at https://www.drugsincontext.com/wp-content/uploads/2019/03/dic.212572-COI.pdf

Acknowledgements: None.

Funding declaration: There was no funding associated with the preparation of this article.

Copyright: Copyright © 2019 Tripathi K, Feuerstein JD. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0 which allows anyone to copy, distribute, and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution: Copyright © 2019 Tripathi K, Feuerstein JD. https://doi.org/10.7573/dic.212572. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0.

Article URL: https://drugsincontext.com/new-developments-in-ulcerative-colitis:-latest-evidence-on-management,-treatment,-and-maintenance

Correspondence: Joseph D Feuerstein, 110 Francis St 8e Gastroenterology, Boston, MA 02215, USA. jfeuerst@bidmc.harvard.edu

Provenance: invited; externally peer reviewed.

Submitted: 20 November 2018; Peer review comments to author: 8 January 2019; Revised manuscript received: 21 March 2019;
Accepted: 21 March 2019; Publication date: 29 April 2019.

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