Ulcerative colitis

Ulcerative colitis

Ulcerative colitis (UC) is a chronic inflammatory bowel disorder of the colon with a relapsing and remitting course^1,2. People with UC frequently present with mucus-like diarrhoea containing blood, as well as abdominal pain and rectal urgency, which are characteristic symptoms of this disorder³.

UC is an idiopathic disorder⁴. Recent studies suggest that that the pathogenesis of UC is multifactorial^1,4,5. Current indications suggest that UC is in part caused by an aberrant response to enteric non-pathogenic bacteria⁵.

UC remains incurable⁶. The goal of treatment is to induce remission, then maintain remission in conjunction with steroid-free management^6,7. In both moderate and severe cases, patients will typically be treated with corticosteroids, immunosuppressants and biologics⁸. Patients may also be prescribed anti-diarrhoeal medications, pain relief and iron supplements on a case-specific basis^9,10. In severe cases, surgical intervention may be required¹¹.

Unmet needs in ulcerative colitis

There are a number of unmet needs yet to be addressed by the clinical management of UC^12,13:

• People with UC still have a diminished quality of life because of UC symptoms and treatment side effects
• UC imposes a psychological burden. People with UC have highlighted the adverse effects of both the condition and the treatment on mental wellbeing, with many noting the prospect of surgery to be of concern
• There are no consistently effective and fast-acting treatments available

References

1. Gajendran M, Loganathan P, Jimenez G, Catinella AP, Ng N, Umapathy C, et al. A comprehensive review and update on ulcerative colitis. Dis Mon. 2019;65(12):100851.
2. Akiho H, Yokoyama A, Abe S, Nakazono Y, Murakami M, Otsuka Y, et al. Promising biological therapies for ulcerative colitis: A review of the literature. World J Gastrointest Pathophysiol. 2015;6(4):219.
3. Perler BK, Ungaro R, Baird G, Mallette M, Bright R, Shah S, et al. Presenting symptoms in inflammatory bowel disease: descriptive analysis of a community-based inception cohort. BMC Gastroenterol. 2019;19(1).
4. Roberts‐Thomson IC, Bryant RV, Costello SP. Uncovering the cause of ulcerative colitis. JGH Open. 2019;3(4):274-276.
5. Ungaro R, Mehandru S, Allen PB, Peyrin-Biroulet L, Colombel J-F. Ulcerative colitis. The Lancet. 2017;389(10080):1756-1770.
6. Tripathi K, Feuerstein JD. New developments in ulcerative colitis: latest evidence on management, treatment, and maintenance. Drugs Context. 2019;8:1-11.
7. Tran CD, Katsikeros R, Abimosleh SM. Current and novel treatments for ulcerative colitis. In: Ulcerative colitis from genetics to complications. Shennak MM, editor. Internet: InTech; 2012. p. 978-953.
8. Feuerstein JD, Cheifetz AS. Crohn Disease: Epidemiology, Diagnosis, and Management. Mayo Clin Proc. 2017;92(7):1088-1103.
9. Garud S, Peppercorn MA. Review: Ulcerative colitis: current treatment strategies and future prospects. Therap Adv Gastroenterol. 2009;2(2):99-108.
10. Sinopoulou V, Gordon M, Dovey TM, Akobeng AK. Interventions for the management of abdominal pain in ulcerative colitis. Cochrane Database Syst Rev. 2021;2021(7).
11. Biondi A, Zoccali M, Costa S, Troci A, Contessini-Avesani E, Fichera A. Surgical treatment of ulcerative colitis in the biologic therapy era. World J Gastroenterol. 2012;18(16):1861.
12. Danese S, Allez M, van Bodegraven AA, Dotan I, Gisbert JP, Hart A, et al. Unmet Medical Needs in Ulcerative Colitis: An Expert Group Consensus. Dig Dis. 2019;37(4):266-283.
13. Schoefs E, Vermeire S, Ferrante M, Sabino J, Lambrechts T, Avedano L, et al. What are the unmet needs and most relevant treatment outcomes according to patients with inflammatory bowel disease? A qualitative patient preference study. J Crohns Colitis. 2023;17(3):379-388.