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Licensed Unlicensed Requires Authentication Published by De Gruyter August 8, 2018

Pharmacotherapy of ulcerative colitis – current status and emerging trends

  • Hilal Ahmad and Vijay L. Kumar EMAIL logo

Abstract

Ulcerative colitis (UC) is a chronic mucosal inflammation of the large intestine restricted to the rectum and colon. Its clinical course follows an intermittent pattern with episodes of relapse, followed by remission and eventually resulting in mucosal damage. Although there is no permanent cure for UC, the currently available pharmacotherapy aims to induce and maintain clinical remission, promote the healing of colonic mucosa and avert any surgical intervention. The conventional drug therapy comprising of 5-aminosalicylates, thiopurines and corticosteroids has advanced recently in terms of formulations and dosing schedule, resulting in improved efficacy, safety and compliance. Calcineurin inhibitors, such as cyclosporin and tacrolimus, have emerged as steroid sparing agents. The treatment paradigm of UC patients who are refractory to conventional drugs has changed in view of the availability of biologics. Currently, there are four biologics approved by the US FDA for the treatment of UC, namely, infliximab, adalimumab, golimumab and vedolizumab, and several others are undergoing clinical trial. In this comprehensive review, the advantages and limitations of the medical therapy of UC are elaborated with an emphasis on the pharmacokinetic and pharmacodynamic aspects of the drugs.


Corresponding author: Professor Vijay L. Kumar, Department of Pharmacology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India, Phone: 91-11-26593681, Fax: 91-11-26588663

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Received: 2016-02-06
Accepted: 2018-05-04
Published Online: 2018-08-08
Published in Print: 2018-11-27

©2018 Walter de Gruyter GmbH, Berlin/Boston

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