Contemporary Management of Ulcerative Colitis

Large Intestine (B Cash, Section Editor)
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Abstract

Purpose of Review

We discuss the newest evidence-based data on management of ulcerative colitis (UC). We emphasize risk-stratification, optimizing medical therapies, and surgical outcomes of UC.

Recent Findings

Recent medical advances include introduction of novel agents for UC. Vedolizumab, an anti-adhesion molecule, has demonstrated efficacy in moderate to severe UC. Tofacitinib, a small molecule, has also demonstrated efficacy. Data on optimization of infliximab show the superiority of combination therapy with azathioprine over monotherapy with infliximab or azathioprine alone. Data on anti-tumor necrosis factor-alpha (anti-TNF) therapeutic drug monitoring also hold promise, as do preliminary data on the dose escalation of infliximab in severe hospitalized UC. Surgical outcome data are reassuring, with new fertility data showing the effectiveness of in vitro fertilization.

Summary

UC management is multi-disciplinary and changing. While novel therapies hold promise, better optimization of our current arsenal will also improve outcomes.

Keywords

Ulcerative colitis Management Review Therapeutic drug monitoring 

Notes

Compliance with Ethical Standards

Conflict of Interest

Rohini Vanga declares no conflict of interest.

Millie Long reports grants and personal fees from Takeda and personal fees from Pfizer, AbbVie, UCB, Target, and Pharmasolutions, outside the submitted work.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Medicine, Division of Gastroenterology and HepatologyUniversity of North Carolina at Chapel HillChapel HillUSA
  2. 2.Center for Gastrointestinal Biology and DiseaseChapel HillUSA

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