Ulcerative colitis: prevention of relapse

Abstract

The clinical management of ulcerative colitis (UC) involves first treating the acute symptoms to induce remission, and then successfully maintaining it. Oral 5-aminosalicylic acids are safe and useful for maintaining remission in patients with UC. In terms of adherence, a once-daily form of 5-aminosalicylic acid is superior in maintaining remission as compared with split dosing. Patients at high risk of relapse may be candidates for treatment with thiopurines and/or biologics in the early stages of UC. Calcineurin inhibitors, such as cyclosporine and tacrolimus, are effective for severe, steroid-refractory UC patients. It is suggested that these patients use thiopurines as their maintenance therapy once they achieve remission with calcineurin inhibitors. Recent studies have confirmed that biologics are effective for inducing clinical and endoscopic remission of UC, and thus they may improve long-term prognosis of UC.

Keywords::

• adherence
• aminosalicylates
• biologics
• immunomodulators
• prevention of relapse
• ulcerative colitis

Financial & competing interests disclosure

The authors have received research support grants from Abbott (Japan), Ajinomoto Pharma, Asahi Kasei Kuraray Medical, AstraZeneca Pharmaceuticals, Janssen Pharmaceuticals, JIMRO, Nissin Kyorin Pharmaceutical Co., Otsuka Pharma, Tanabe Mitsubishi Seiyaku, UCB (Japan), UMN Pharma and Zeria Pharmaceutical. The authors have consulted for Abbott (Japan), Asahi Kasei Kuraray Medical, Nissin Kyorin Pharmaceutical Co., Tanabe Mitsubishi Seiyaku and Zeria Pharmaceutical. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Notes

CRP: C-reactive protein; ESR: Erythrocyte sedimentation rate.