Guidelines on therapeutics in ulcerative colitis in adult patients (update)
DOI:
https://doi.org/10.22516/25007440.1288Keywords:
Ulcerative colitis, diagnosis, therapy, biological therapy, clinical practice guidelineAbstract
Introduction: In 2020, the Colombian Association of Gastroenterology updated the clinical practice guideline for the diagnosis and treatment of ulcerative colitis. Since the publication of that guideline, new biologicals have been approved for ulcerative colitis, with diverse routes of administration, and new oral small molecules, so an update of the management of the disease focusing on new treatments was considered necessary.
Materials and methods: This update was conducted by a multidisciplinary team with support of the Colombian Association of Gastroenterology and the Institute of Clinical Research of the Universidad Nacional de Colombia. A systematic literature review of systematic reviews and primary studies in different databases with their respective quality assessment was performed. For some outcomes of randomized clinical trials, meta-analyses were performed. The certainty of evidence and strength of recommendations were performed using GRADE methodology. The details of the methodology and technical annexes can be found in the long version of the guideline available at: www.gastrocol.com.
Results: Recommendations and algorithms for induction and maintenance treatment of moderate to severe ulcerative colitis were updated, and guidelines were provided on the use of new biologicals such as vedolizumab, infliximab, upadacitinib, tofacitinib, ozanimod and mirikizumab, as well as switching to vedolizumab and subcutaneous infliximab.
Conclusions: The importance of the use of biological therapy or other small molecules in the face of conventional therapy failure to improve clinical outcomes and quality of life in patients with moderate and severe ulcerative colitis was established.
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