Ulcerative colitis
ICD-10 K51 · ICD-11 DD71

What Is the Maintenance Treatment for Moderate-to-Severe Ulcerative Colitis in Adults in Corticosteroid-Induced Remission?

Adult outpatients with moderate-to-severe ulcerative colitis who have achieved clinical remission — typically corticosteroid-induced — face a critical inflection point: how to sustain that remission without continued corticosteroid exposure. This protocol addresses exactly that scenario.

Clinical Scenario

Adult outpatient with moderate-to-severe ulcerative colitis currently in clinical remission, typically induced by corticosteroids. The therapeutic challenge is preserving this remission state and avoiding relapse over a 6- to 18-month horizon.

Treatment Approach (Partial)

An oral thiopurine-class agent is used for maintenance of remission, rather than leaving the patient without active therapy. The specific agent, selection criteria, and management details are in the full protocol.

Clinical Goals

Maintenance of corticosteroid-free clinical remission and prevention of disease relapse, with outcomes evaluated between 6 and 18 months.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1053/j.gastro.2024.10.001

In adult outpatients with moderate-to-severe UC in remission, the AGA suggests using thiopurine monotherapy, rather than no treatment, for maintenance of remission, typically induced by corticosteroids.

Maintenance of remission was defined as prevention of relapse after corticosteroid-induced remission (5 trials) or as the ability to maintain a corticosteroid-free remission in patients on long-standing thiopurine therapy (2 trials) evaluated between 6 and 18 months.

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