Reviewing treatments and outcomes in the evolving landscape of ulcerative colitis

Abstract

Ulcerative colitis (UC) is a chronic inflammatory disease extending proximally from the rectum to varying lengths of the colon that is characterized by alternating cycles of relapse and remission. Therapeutic goals for patients with active UC include induction and maintenance of remission and improvement in quality of life, as well as mucosal healing, a clinical outcome recently recognized in treatment guidance as being equally important. Mucosal healing is associated with favorable long-term patient outcomes related to remission, surgery, hospitalization, and quality of life. Given the increasing number of newer therapies available, it is important to properly position the use of each agent within the landscape of established UC therapies, evolving therapeutic goals, and established guidelines. Extent of disease is important to consider when selecting a treatment, as is an understanding of the short- and long-term outcomes (e.g. corticosteroid-free remission, mucosal healing) associated with each treatment. The purpose of this narrative review is to provide an overview of newer therapies for the treatment of UC and how they may best fit in the evolving landscape of UC.