Dr Edward Barnes discusses new approaches for improving patient outcomes in acute severe ulcerative colitis.
Associate Professor, Division of Gastroenterology and Hepatology, University of North Carolina; Co-Director, Multidisciplinary Inflammatory Bowel Diseases Center, University of North Carolina, Chapel Hill, North Carolina
When we think about acute severe UC, I think one of the critical things to remember is that these are some of the sickest patients and the sickest presentations that we're going to be managing in the disease course of a patient with UC.As I mentioned, this is a critical presentation for that patient with acute severe UC because they're at high risk for colectomy during that initial hospital admission.
When we think about how we make that decision of when we would re-dose someone with acute severe UC and that accelerated frequency dosing strategy, it's driven by that patient's clinical presentation.
In the past couple of years, we've seen the emergence of cyclosporine as a bridge to our novel biologics, such as. This has opened up the patient population where we would use cyclosporine — particularly in our center, which is one where we use a lot of cyclosporine, including in patients with loweror the sicker patients whom we think have had a lot of protein loss and in whom we might not want to use infliximab, for the reasons I mentioned.
In the TACOS trial, at their primary outcome of clinical response at day 7, more patients receiving 10 mg orally three times daily achieved that outcome compared with standard of care , suggesting that tofacitinib at this higher dose can be quite effective as an induction therapy. as well in the treatment of acute severe UC.
Ulcerative Colitis Center Of Excellence Ulcerative Colitis Ulcerative Colitis (UC) UC - Ulcerative Colitis Clostridium Difficile Colitis C. Diff Colitis Ciclosporin Cyclosporine Cyclosporin Neoral Colorectal Cancer Colorectal Cancer (CRC) Crohn's Disease Crohn Disease Regional Enteritis Crohn Crohn’S
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