When a 5 asa agent no longer maintains remission in patients with ulcerative colitis
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The goals of treatment for ulcerative colitis (UC) are to induce remission, maintain remission, and facilitate mucosal healing. Historically, a step-up approach has been used to accomplish these goals. Agents with the least toxicity are initially used, and agents are added or changed based on the treatment response or toxicity. The treatment of mild to moderate UC usually begins with 5-aminosalicylate acid (5-ASA), an anti-inflammatory agent. Corticosteroids may be used to reduce inflammation and to help induce disease remission when a flair of symptoms occurs. Other agents, such as thiopurine immunomodulator and biologic agents, are used to treat more severe disease, and surgery may be indicated if medical treatment fails.
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