Ulcerative Colitis Medical Therapy Clinical Practice Guidelines (ECCO, 2022)

Clinical guidelines on the medical treatment of ulcerative colitis were published in January 2022 by the European Crohn's and Colitis Organization (ECCO) in the Journal of Crohn's and Colitis.^[1]

Mildly to Moderately Active Ulcerative Colitis

For remission induction in patients with mildly to moderately active ulcerative colitis, 5-aminosalicylates (5-ASAs) at a dose of at least 2 g/day are recommended.

Topical (rectal) 5-ASAs at a dose of at least 1 g/day are recommended to induce remission in active distal colitis.

Monotherapy with thiopurines is recommended to maintain remission in patients who have steroid-dependent ulcerative colitis or cannot tolerate 5-ASAs.

Moderately to Severely Active Ulcerative Colitis

Treatment with anti-tumor necrosis factor (TNF) agents (infliximab, adalimumab, and golimumab) is recommended for remission induction in patients with moderate-to-severe ulcerative colitis who do not adequately respond to or cannot tolerate conventional therapy.

Treatment with tofacitinib is recommended for remission induction in patients with moderate-to-severe ulcerative colitis who do not adequately respond to or cannot tolerate conventional therapy.

Treatment with ustekinumab is recommended to induce remission in patients with moderately to severely active ulcerative colitis who do not adequately respond to or cannot tolerate conventional therapy.

An anti-TNF agent (infliximab, adalimumab, or golimumab) is recommended to maintain remission in patients with ulcerative colitis in whom a response to induction therapy was achieved with the same drug.

Vedolizumab is recommended to maintain remission in patients with ulcerative colitis in whom a response to induction therapy was achieved with the same drug.

Tofacitinib is recommended to maintain remission in patients with ulcerative colitis in whom a response to induction therapy was achieved with the same drug.

Ustekinumab is recommended to maintain remission in patients with ulcerative colitis in whom a response to induction therapy was achieved with the same drug.

For more information, please go to Ulcerative Colitis.

Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.

Cite this: Ulcerative Colitis Medical Therapy Clinical Practice Guidelines (ECCO, 2022) - Medscape - Mar 01, 2022.

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