Treatment of Moderately to Severely Active Ulcerative Colitis of Any Extent
This protocol covers the management of moderately to severely active ulcerative colitis, regardless of colonic extent. The primary clinical objective at this level of activity is induction of remission.
Clinical Scenario
Moderately to severely active ulcerative colitis of any extent — spanning the full range of disease severity above mild activity, irrespective of how much of the colon is involved.
Treatment Goals
Induction of clinical and endoscopic remission, reassessed within 8 weeks: absence of rectal bleeding, normalized stool frequency, and a Mayo endoscopic score of 0 or 1.
Treatment Approach
Oral corticosteroid-based therapy is used to induce remission, with the specific agent guided by whether the disease is moderately or severely active.
References
DOI: 10.14309/ajg.0000000000003463
- In patients with moderately to severely active UC of any extent, we recommend oral systemic corticosteroids to induce remission.
- In patients with moderately active UC, we recommend oral budesonide MMX for induction of remission.
- Patients with mildly to moderately active UC should be reassessed to determine response to induction therapy within 8 weeks.
- In clinical trials, the definition of clinical remission has been a MES of 0 or 1, stool frequency of ≤1, and absence of rectal bleeding.