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Nonbiological therapeutic management of ulcerative colitis

Nicolò Mezzina1, Sophia Elizabeth Campbell Davies2, Sandro Ardizzone1

  • 1a Gastrointestinal Unit, ASST Fatebenefratelli Sacco - Department of Biochemical and Clinical Sciences "L. Sacco" , University of Milan , Milano , Italy.

Expert Opinion on Pharmacotherapy
|September 18, 2018
PubMed
Abstract

Insights

Nonbiological therapies remain crucial for ulcerative colitis (UC) management, offering a safe and cost-effective approach. These treatments, including 5-aminosalicylic acid and corticosteroids, are effective for mild-to-moderate and severe UC, respectively.

Area of Science:

  • Gastroenterology
  • Internal Medicine
  • Pharmacology

Background:

  • Ulcerative colitis (UC) treatment is evolving with new biological agents.
  • Nonbiological drugs remain foundational, particularly for mild-to-moderate UC.
  • These agents offer a proven safety profile and cost-effectiveness compared to biologics.

Purpose of the Study:

  • To review current knowledge on nonbiological therapies for UC.
  • To summarize the latest clinical evidence for these treatments.

Main Methods:

  • Literature review of nonbiological therapies for ulcerative colitis.
  • Analysis of clinical evidence for efficacy and safety.

Main Results:

  • Combined oral and rectal 5-aminosalicylic acid (5-ASA) improves remission.
  • Corticosteroids are primary for moderate-to-severe UC.
  • Azathioprine with biologics shows superior efficacy to monotherapy; cyclosporine is effective but challenging to manage.

Conclusions:

  • Nonbiological therapies are essential for UC management.
  • Evidence for probiotics in UC requires further demonstration.
  • Cytapheresis has a limited role in current UC treatment.
Keywords:
5-ASAAZAIBDUCcolitisconventionalconventional therapynon-biologicalulcerativeulcerative colitis

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