Korean J Med.
2009 Jun;76(6):654-660.
Advances in ulcerative colitis therapy
- Affiliations
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- 1Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Abstract
- Ulcerative colitis is an idiopathic inflammatory bowel disease characterized by colonic mucosal inflammation and chronic relapsing episodes. The initial therapeutic approach depends on both the extent of colonic involvement and the severity of the disease process at presentation. The mainstay of ulcerative colitis therapy is the administration of 5-aminosalicylic acid (5-ASA) or steroid. Additional medical therapy or colectomy should be considered if the patient remains symptomatic despite conventional therapy, regardless of the extent of colonic involvement. Cyclosporins are effective as a short-term rescue therapy for steroid-refractory ulcerative colitis. Recently, new 5-ASA and steroid formulations with altered delivery, dosing regimens, and less frequent administration have been introduced and demonstrated to be efficacious in active mild to moderate colitis. Infliximab is given to try to avoid the need for colectomy and has proven efficacious in ulcerative colitis. This review outlines the standard therapy for ulcerative colitis and discusses new insights into the recent trend focusing on new therapies, including biological agents and leukocytapheresis.