| Theme |
The Newest Strategies for Severe Ulcerative Colitis |
| Title |
Indications for Immunosuppressive Agents for Ulcerative Colitis |
| Author |
Makoto Naganuma |
Department of Internal Medicine, School of Medicine, Keio University |
| Author |
Toshifumi Hibi |
Department of Internal Medicine, School of Medicine, Keio University |
| [ Summary ] |
Recently, substantial gains have been made in the treatment of inflammatory bowel disease. For ulcerative colitis (UC), 5-ASA agents are effective for use in mild to moderate disease and as maintenance therapies. Although corticosteroids have been shown to be highly effective in short-term treatment of active UC, their value in maintenance therapy has never been shown. Furthermore, there are some patients who are resistant to, or dependent on corticosteroids. Cyclosporin A (CsA) is a useful agent for treatment of active severe UC, which is unresponsive to corticosteroids. It may be used as a bridge to other immunosuppressive therapies and where surgery is not desirable. 6-MPAZA has no role in active severe disease because of a slow induction time, of approximately 3-4 months. These purine analogues are useful for steroid-dependent UC patients and as maintenance therapy for CsA responder. |