Where are we going with ulcerative colitis management?

Figures & data

Table 1. Take-home messages: current usage of therapies in ulcerative colitis.

Medication	Year of introduction (approx.)*	Current recommended usage
Corticosteroids	1955	For short-term use in acute or acute-on-chronic colitis and as a bridge to more definitive treatment
Salazopyrin (sulfasalazine)	1962	For maintenance (seldom used nowadays)
Thiopurine analogs	1966	Maintenance only, with or without biologics (or cyclosporine); may be introduced concomitantly with corticosteroids
5-Aminosalicylates	1981	For short-term use in acute mild colitis, and for maintenance
Methotrexate	1989	Not recommended, pending further investigation
Calcineurin inhibitors^‡	1990	Cyclosporine as rescue therapy in acute severe colitis, not for maintenance
Infliximab	2001	For acute and maintenance therapy
Adalimumab^§	2009	For acute and maintenance therapy

*This refers to landmark reports of open or blinded trials of the use of these agents in ulcerative colitis, not the dates when these agents were approved for use by national regulatory authorities.

^‡Calcineurin inhibitors are not to be co-administered with anti-TNF-α agents.

^§Approved in the USA and Europe in 2012. Further clinical experience is warranted to determine its place in the treatment of ulcerative colitis.