Jul 28, 2012

Update on the management of ulcerative colitis

Acta Medica Iranica
Sahar Taba Taba VakiliNasser Ebrahimi Daryani

Abstract

The present treatment goals for inflammatory bowel diseases (IBD) especially ulcerative colitis (UC) include rapid induction of clinical remission, steroid-free maintenance of clinical remission, mucosal healing and improvement of quality of life in UC patients. Immunomodulators have been reserved for steroid- dependent or steroid- refractory UC patients. Among these agents, azathioprine/6-mercaptopurine should be used for maintenance of remission in quiescent UC. Calcineurin inhibitors can be prescribed as a short-term rescue therapy in steroid- refractory UC patients, but the long term efficacy of these agents remains unclear. According to retrospective studies, methotraxate is not recommended for inducing and maintaining remission in UC. Novel biological therapies targeting different specific immunological pathways continue to be developed and introduced for a variety of clinical scenarios in IBD. Infliximab is currently used for induction and maintenance therapy in patients who have moderately to severely active UC with an inadequate response to conventional agents such as aminosalicylates, corticosteroids, or immunomodulators. Other anti-TNF agents and biologic therapies are undergoing evaluation in clinical trials for the...Continue Reading

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Mentioned in this Paper

Biochemical Pathway
Mercaptopurine
Immunomodulators
Immunologic Adjuvants
Biological Products
Mucositis
Corticosteroids, topical for treatment of hemorrhoids and anal fissures
Aminosalicylate
Azathioprine
Cancer Remission

About this Paper

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