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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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When a 5-ASA Agent No Longer Maintains Remission in a Patient
With Ulcerative Colitis
Case: A 28-Year-Old Man
Case (cont)
Sequential Therapies for UC
Case: Next Steps
Case: Next Steps
Treatment of Panulcerative Colitis That Is Unresponsive to Oral Mesalamine 2.4 g/d
Treatment of Panulcerative Colitis That Is Unresponsive to Oral Mesalamine 2.4 g/d (cont)
Treatment of Panulcerative Colitis That Is Unresponsive to Oral Mesalamine 2.4 g/d (cont)
Efficacy and Safety of Budesonide MMX
Budesonide MMX After Treatment With 5-ASA
Case: Conclusion
Options for Maintaining Remission
Patient Adherence
Adherence Is Dependent on Multiple Factors
Summary
Abbreviations
References
References (cont)