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Drugs for Treatment of Ulcerative Colitis in IBD01:29

Drugs for Treatment of Ulcerative Colitis in IBD

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Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
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Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
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Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
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Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
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Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
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Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
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  11. Comparative Efficacy Of Biologics And Small Molecule Therapies In Improving Patient-reported Outcomes In Ulcerative Colitis: Systematic Review And Network Meta-analysis

Comparative Efficacy of Biologics and Small Molecule Therapies in Improving Patient-Reported Outcomes in Ulcerative Colitis: Systematic Review and Network Meta-Analysis

Mohammad Shehab1,2, Amro Hassan1, Fatema Alrashed3

  • 1Division of Gastroenterology, Department of Internal Medicine, Mubarak Alkabeer University Hospital, Jabriya, Kuwait.

Inflammatory Bowel Diseases
|August 13, 2024

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View abstract on PubMed

Summary
This summary is machine-generated.

Upadacitinib effectively treats ulcerative colitis (UC) by improving clinical remission and quality of life (HRQoL). Guselkumab also shows significant benefits for HRQoL in UC patients during induction.

Area of Science:

  • Gastroenterology and immunology
  • Pharmacological research
  • Clinical trial analysis

Background:

  • Ulcerative colitis (UC) significantly impacts patient quality of life (HRQoL).
  • HRQoL is increasingly recognized as a critical treatment target in UC management.
  • Various biologics and small molecule therapies are available for UC treatment.

Purpose of the Study:

  • To compare the efficacy of different UC therapies.
  • To evaluate patient-reported outcomes (PROs) and HRQoL improvements.
  • To identify superior treatments for UC based on patient-centered endpoints.

Main Methods:

  • Systematic review and network meta-analysis of EMBASE, MEDLINE, and Cochrane Central databases.
  • Primary endpoint: clinical remission using the PRO-2 score (stool frequency and rectal bleeding).
Keywords:
HRQoLIBDbiologicsefficacy

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  • Secondary endpoint: HRQoL improvement (Inflammatory Bowel Disease Questionnaire score change).

    • Main Results:

    • All evaluated drugs improved PRO-2 scores compared to placebo during induction.
    • Upadacitinib demonstrated superiority in improving PRO-2 scores over most other medications.
    • Guselkumab showed the highest ranking for HRQoL improvement during induction, followed by upadacitinib.

    Conclusions:

    • Upadacitinib ranked first for PRO-2 clinical remission in both induction and maintenance phases.
    • Guselkumab, mirikizumab, tofacitinib, and upadacitinib improved HRQoL compared to placebo.
    • During maintenance, tofacitinib ranked highest for HRQoL improvement in UC patients.
    patient-reported outcomes
    small molecules
    ulcerative colitis