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10-15% of patients with ulcerative colitis experience a severe episode of colonic inflammation that does not respond to mesalazine and oral corticosteroids. These patients require hospitalisation and treatment with intravenous corticosteroids. However, 25% of these patients do not respond to treatment. In these cases, intravenous cyclosporin is effective. Infliximab, an antibody against tumour necrosis factor alpha, is also beneficial. With these new treatment options, the colectomy rate in the acute phase has declined to about 35%. Other new therapies are under investigation in phase 2 and 3 trials. Surgery remains an important treatment option. Patients, gastroenterologists and surgeons should be involved in the clinical decision-making process.

Type

Journal article

Journal

Ned Tijdschr Geneeskd

Publication Date

07/01/2006

Volume

150

Pages

12 - 17

Keywords

Adrenal Cortex Hormones, Antibodies, Monoclonal, Colitis, Ulcerative, Cyclosporine, Gastrointestinal Agents, Humans, Immunosuppressive Agents, Infliximab, Patient Care Management, Remission Induction