Treatment options for refractory ulcerative colitis: Small molecules, big effects

Marafini, Irene; Roseira, Joana; Duijvestein, Marjolijn

http://hdl.handle.net/10400.1/26358

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Authors

Marafini, Irene

Roseira, Joana

Duijvestein, Marjolijn

Abstract(s)

Although the majority of patients with ulcerative colitis (UC) have a mild-to-moderate disease, approximately 10%–15% experience a severe disease course and require immunosuppressive therapies.1 A better understanding of the mechanisms sustaining the pathogenic process in inflammatory bowel diseases (IBD) has largely contributed to expand the therapeutic armamentarium for this group of patients. Alongside with conventional therapies, monoclonal antibodies against tumour necrosis factor-α, α4β7 integrin (vedolizumab), interleukin (IL)-12/IL-23 p40 subunit (ustekinumab), and small molecules inhibiting intracellular pathways downstream to cytokine receptors (tofacitinib, filogotinib and upadacitinib), have entered into the clinic for the treatment of UC.2 However, selecting the appropriate medical therapy for each patient at a given stage of the disease natural history is an increasingly complex task for clinicians, as no prediction for treatment effect can be made in the individual patient.