Abstract

MAGRO, Fernando et al. Maintenance Therapy in Moderate to Severe Ulcerative Colitis. J Port Gastrenterol. [online]. 2011, vol.18, n.4, pp.170-178. ISSN 0872-8178.

INTRODUCTION: Ulcerative Colitis (UC) is a chronic inflammatory disease, highly affecting quality of life. More extensive UC is associated with an increased risk of mortality and colorectal cancer. In moderate to severe corticodependent or corticoresistant cases, immunosuppression is indicated to induce and maintain remission while reducing or withdrawing steroids. OBJECTIVES: To update our knowledge on therapeutic strategies for the medical management of UC and define guidelines for clinical practice through evidence-based national recommendations. METHODS: After performing a meta-analysis, a consensus meeting envolving gastroenterology experts was done using the Nominal Group Technique. RESULTS: Immunosuppression significantly increased the proportion of patients who remained on remission (RR = 1.58; IC 95% 1.40 - 1.78). A positive association between early age of onset and the need for immunosuppression was identified; no association was found between immunosuppression and patients’ age, sex and disease duration. CONCLUSIONS: There is evidence that both Infliximab and Azathioprine are useful drugs able to maintain disease remission. Infliximab is the first line drug in patients with moderate UC refractory to Azathioprine.

Keywords : Ulcerative colitis; Immunosuppression; Guidelines.

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