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Optimal management of steroid-dependent ulcerative colitis

Authors Khan H, Mehmood F, Khan N

Received 27 June 2015

Accepted for publication 21 September 2015

Published 12 November 2015 Volume 2015:8 Pages 293—302


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Professor Andreas M Kaiser

Hafiz M Waqas Khan,1 Faisal Mehmood,1 Nabeel Khan2

1Department of Medicine, King Edward Medical University, Lahore, Pakistan; 2Section of Gastroenterology, University of Pennsylvania Perelman School of Medicine, Philadelphia VA Medical Center, Philadelphia, PA, USA

Abstract: Ulcerative colitis (UC) is a chronic inflammatory condition that is variable in both extent and severity of disease as well as response to therapy. Corticosteroids (CSs) were the first drugs used in the management of UC and are still used for induction of remission. However, because of their extensive side-effect profile, they are not utilized for maintenance of remission. In view of this, CS-free remission has become an important end point while evaluating therapeutic agents used in the management of UC. This review highlights the results of various studies conducted to evaluate the efficacy of different medications to attain CS-free remission in the setting of active UC. The drugs reviewed include established agents such as thiopurines, methotrexate, infliximab, adalimumab, vedolizumab, golimumab, and newer experimental agents, and if all else fails, colectomy will be performed. The efficacy of these drugs is evaluated individually. Our aim is to provide a synopsis of the work done in this field to date.

Keywords: ulcerative colitis, steroid dependent, thiopurines, MTX, adalimumab, infliximab

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