Guideline Issued for Treatment of Mild, Moderate Ulcerative Colitis

Guideline Issued for Treatment of Mild, Moderate Ulcerative Colitis

Guideline Issued for Treatment of Mild, Moderate Ulcerative
Colitis
 
A new clinical guideline from the American Gastroenterological
Association (AGA) published Dec 18 in Gastroenterology focuses
on the medical management of patients with mild-to-
moderate ulcerative colitis (UC).

To inform the guideline, Siddharth Singh, MD, from the University of California in San Diego, and colleagues compiled the clinical evidence in accordance with the Grading of Recommendations

Assessment, Development, and Evaluation framework.
In the guideline, Cynthia W. Ko, MD, from the University of
Washington in Seattle, and colleagues note that most UC patients
have a mild-to-moderate course characterized by periods of
activity or remission. For patients with extensive mild-to-moderate UC, using standard-dose mesalamine or diazo-bonded 5-ASA is recommended rather than low-dose mesalamine, sulfasalazine, or no treatment. Rectal mesalamine should be added to oral 5-ASA for patients with extensive or left-sided mild-to-moderate UC.

High-dose mesalamine with rectal mesalamine is recommended
for patients with mild-to-moderate UC with suboptimal response to standard-dose mesalamine or diazo-bonded 5-ASA. Once-daily
dosing is recommended rather than multiple-daily dosing for
patients with mild-to-moderate UC being treated with oral
mesalamine. For induction of remission, standard-dose oral
mesalamine or diazo-bonded 5-ASA is recommended rather than
budesonide MMX or controlled ileal-release budesonide.

“We identified several knowledge gaps and areas for future research in this patient population,” Ko and colleagues write. “Due to evidence gaps, the AGA makes no recommendation for use of probiotics, curcumin, or fecal microbiota transplantation in patients with mild-to- moderate UC.”

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