Clinical Gastroenterology Vol.31 No.6(4-1)

Theme How Do You Choose Treatment Strategies for IBD Patients with a Critical Situation?
Title Anti—TNF—α Antibody as Remission Maintenance Therapy for Steroid—dependent Ulcerative Colitis
Publish Date 2016/06
Author Tetsuyoshi Iwasaki Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine
Author Masayuki Saruta Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine
[ Summary ] In some patients with steroid‒dependent ulcerative colitis (UC), recurrence easily occurs during tapering of steroid therapy, although steroids are effective as remission‒induction therapy for active UC. Anti‒TNF‒α antibody treatment is esteemed as a novel promising treatment strategy for refractory UC because of its high remission induction and maintenance rates in several clinical studies. Thiopurine is a classically useful treatment of steroid dependent UC, and it induces steroid reduction and maintains long‒term remission. Easy administration of anti‒TNF‒α antibody for steroid‒dependent UC, therefore, should not be recommended in the future. Instead of anti‒TNF‒α antibody treatment, thiopurine should be used as the first‒line treatment of steroid‒dependent UC. Thus, the indication of anti‒TNF‒α antibody treatment should be considered after evaluating the efficacy of thiopurine.
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