AGA’s first-ever living guideline categorizes the 12 available treatments for patients with moderate-to-severe ulcerative colitis based on efficacy. This approach aims to streamline your decision-making, with a new recommendation to prioritize advanced therapies and/or immunomodulators rather than using a step-up approach following 5-aminosalicylates (5-ASA) failure.
As a living guideline, semiannual reviews of this body of evidence will be conducted by the authors, and recommendations will be updated when indicated.
Key takeaways:
- Factors influencing treatment decisions: A patient’s risk of disease complications, disease severity, and additional considerations, including comorbidities, age, safety risks, and pregnancy status.
- Prior treatment history may impact the effectiveness of future therapies, highlighting the need for personalized treatment plans.
- Medications with the highest efficacy for patients without prior exposure to advanced therapies: infliximab, vedolizumab, ozanimod, etrasimod, upadacitinib, risankizumab, and guselkumab.
- Medications with the highest efficacy for patients with prior exposure to advanced therapies, especially those with TNF antagonist failure: tofacitinib, upadacitinib, and ustekinumab.
Read the full AGA clinical guideline on pharmacological management of moderate-to-severe ulcerative colitis, published in the December issue of Gastroenterology.
