Search

Ustekinumab (UST) targets the common subunit (p40) of interleukins-12/23, 1,2 approved for intravenous (IV) induction of remission in moderate-to-severe Crohn's disease (CD), followed by subcutaneous (SC) doses for maintenance of remission. 3,4 The role of IV reinduction of UST in patients already on every-4-week (Q4) maintenance with partial response or loss of response (LOR) is unclear. 5 The aim was to assess response and remission rates for UST IV reinduction in patients with CD with partial response or LOR who already were on Q4 SC dosing and had failed prior biological therapies., (Copyright © 2021 AGA Institute. Published by Elsevier Inc. All rights reserved.)

Introduction : Despite the introduction of novel therapies and treatment strategies for ulcerative colitis (UC), many patients develop acute, severe episodes, warranting prompt care and aggressive management. There is a significant unmet need to improve outcomes in these patients. Clinicians must be able to identify those that will have worse prognosis and plan an aggressive therapy with an early/proactive adjustments in management if needed. Areas covered : The aim of this review is to evaluate the most recent evidence on the assessment and management of patients with acute severe ulcerative colitis. We searched the mainstream literature search engines for the most recent evidence on diagnosis and management of acute UC. Expert Opinion : The approach to patients with severe UC includes clinical and endoscopic assessment of disease severity and ruling out over-infections. While intravenous corticosteroids remain the first line therapy for acute severe colitis, many patients do not respond and require escalation to calcineurin inhibitors or infliximab, and may ultimately require colectomy. Even though several novel therapies are available or in development, their role in acute severe episodes of colitis is unknown.