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Updated: May 17, 2026
08:58
Analyzing Beneficial Effects of Nutritional Supplements on Intestinal Epithelial Barrier Functions During Experimental Colitis
Published on: January 5, 2017
Randomized controlled trials in steroid dependent and in severe colitis.
Maria Lia Scribano1, Laura Cantoro, Luigi Giovanni Papparella
1UOC Gastroenterologia AO San Camillo Forlanini, Circonvallazione Gianicolense, Roma, Italy. marialiascribano@virgilio.it
Reviews on Recent Clinical Trials
|October 25, 2012
Summary
For severe ulcerative colitis, intravenous steroids are standard. Cyclosporine and infliximab offer short-term alternatives to colectomy for steroid-refractory patients, while azathioprine shows promise for steroid-free remission.
Area of Science:
- Gastroenterology and Internal Medicine
- Clinical pharmacology of inflammatory bowel disease
Background:
- Severe ulcerative colitis (UC) treatment primarily relies on intravenous steroids.
- Identifying effective adjunct therapies to steroids is crucial for patients unresponsive to corticosteroids, aiming to prevent colectomy.
Purpose of the Study:
- To review current evidence on adjunctive therapies for severe ulcerative colitis.
- To evaluate the efficacy of treatments beyond steroids in achieving clinical response and steroid-free remission, potentially avoiding colectomy.
Main Methods:
- Review of randomized controlled trials and published data on treatments for severe ulcerative colitis.
- Analysis of evidence for adjunctive therapies including cyclosporine, infliximab, antibiotics, bowel rest, heparin, and azathioprine.
Main Results:
- Cyclosporine and infliximab show short-term efficacy for steroid-refractory UC but long-term colectomy prevention data are limited.
- Antibiotics, bowel rest, and heparin lack evidence of additional benefit over steroids in severe UC.
- Azathioprine demonstrates potential in achieving steroid-free remission in steroid-dependent colitis.
Conclusions:
- While steroids are the mainstay, alternative short-term options exist for refractory cases.
- Further research is needed to confirm long-term colectomy avoidance with agents like cyclosporine and infliximab.
- Azathioprine is a promising option for achieving steroid-free remission in select UC patients.
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