Ulcerative colitis – recent and potential methods of treatment - review
DOI:
https://doi.org/10.12775/JEHS.2023.13.03.009Keywords
ulcerative colitis (UC), treatmentAbstract
Introduction and purpose: Ulcerative colitis (UC, colitis ulcerosa) belongs to a group of inflammatory bowel diseases of unexplained etiology. It is a diffuse nonspecific inflammation of the mucosa of the rectum or rectum and colon, leading to ulceration in more severe cases. Despite a decline in the incidence of ulcerative colitis in developed countries, the prevalence continues to rise due to increasingly predominant benign course of the disease with a low mortality rate. The purpose of this review is to summarize latest directions and discoveries in research of ulcerative colitis.
Materials and methods: This review is based on articles published in Pubmed between 2017 and 2022 by searching keywords ulcerative colitis treatment, ulcerative colitis guidelines.
State of knowledge: Currently, many independent scientific societies represent a consensus position on the standard management of patients with UC, while recent therapeutic options are constantly emerging due to intensive research. These options require the involvement of multiple medical centers to determine their position in future guidelines.
Conclusion: Although ulcerative colitis is a disease that is diagnosed and detected relatively easily, due to its chronic nature, relatively high prevalence in the population and lack of causal treatment options, it is an important direction for further research.
References
Segal JP, LeBlanc JF, Hart AL. Ulcerative colitis: an update. Clin Med (Lond). 2021 Mar;21(2):135-139. doi: 10.7861/clinmed.2021-0080. PMID: 33762374; PMCID: PMC8002778.
Kucharzik T, Koletzko S, Kannengiesser K, Dignass A: Ulcerative colitis—diagnostic and therapeutic algorithms. Dtsch Arztebl Int 2020; 117: 564–74. DOI: 10.3238/arztebl.2020.0564
Zagórowicz E, Walkiewicz D, Kucha P, et al. Nationwide data on epidemiology of inflammatory bowel disease in Poland between 2009 and 2020. Pol Arch Intern Med. 2022; 132: 16194. doi:10.20452/pamw.16194
Raine T, Bonovas S, Burisch J, Kucharzik T, Adamina M, Annese V, Bachmann O, Bettenworth D, Chaparro M, Czuber-Dochan W, Eder P, Ellul P, Fidalgo C, Fiorino G, Gionchetti P, Gisbert JP, Gordon H, Hedin C, Holubar S, Iacucci M, Karmiris K, Katsanos K, Kopylov U, Lakatos PL, Lytras T, Lyutakov I, Noor N, Pellino G, Piovani D, Savarino E, Selvaggi F, Verstockt B, Spinelli A, Panis Y, Doherty G. ECCO Guidelines on Therapeutics in Ulcerative Colitis: Medical Treatment. J Crohns Colitis. 2022 Jan 28;16(1):2-17. doi: 10.1093/ecco-jcc/jjab178. PMID: 34635919.
Feuerstein JD, Isaacs KL, Schneider Y, Siddique SM, Falck-Ytter Y, Singh S; AGA Institute Clinical Guidelines Committee. AGA Clinical Practice Guidelines on the Management of Moderate to Severe Ulcerative Colitis. Gastroenterology. 2020 Apr;158(5):1450-1461. doi: 10.1053/j.gastro.2020.01.006. Epub 2020 Jan 13. PMID: 31945371; PMCID: PMC7175923.
Lamb CA, Kennedy NA, Raine T, Hendy PA, Smith PJ, Limdi JK, Hayee B, Lomer MCE, Parkes GC, Selinger C, Barrett KJ, Davies RJ, Bennett C, Gittens S, Dunlop MG, Faiz O, Fraser A, Garrick V, Johnston PD, Parkes M, Sanderson J, Terry H; IBD guidelines eDelphi consensus group, Gaya DR, Iqbal TH, Taylor SA, Smith M, Brookes M, Hansen R, Hawthorne AB. British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults. Gut. 2019 Dec;68(Suppl 3):s1-s106. doi: 10.1136/gutjnl-2019-318484. Epub 2019 Sep 27. Erratum in: Gut. 2021 Apr;70(4):1. PMID: 31562236; PMCID: PMC6872448.
Feuerstein, Joseph D., Alan C. Moss, i Francis A. Farraye. „Ulcerative Colitis”. Mayo Clinic Proceedings 94, nr 7 (1 lipiec 2019): 1357–73. https://doi.org/10.1016/j.mayocp.2019.01.018.
Keshteli AH, Madsen KL, Dieleman LA. Diet in the Pathogenesis and Management of Ulcerative Colitis; A Review of Randomized Controlled Dietary Interventions. Nutrients. 2019; 11(7):1498. https://doi.org/10.3390/nu11071498
Fritsch, Julia, Luis Garces, Maria A. Quintero, Judith Pignac-Kobinger, Ana M. Santander, Irina Fernández, Yuguang J. Ban, i in. „Low-Fat, High-Fiber Diet Reduces Markers of Inflammation and Dysbiosis and Improves Quality of Life in Patients With Ulcerative Colitis”. Clinical Gastroenterology and Hepatology 19, nr 6 (1 czerwiec 2021): 1189-1199.e30. https://doi.org/10.1016/j.cgh.2020.05.026.
Sarbagili-Shabat C, Albenberg L, Van Limbergen J, Pressman N, Otley A, Yaakov M, Wine E, Weiner D, Levine A. A Novel UC Exclusion Diet and Antibiotics for Treatment of Mild to Moderate Pediatric Ulcerative Colitis: A Prospective Open-Label Pilot Study. Nutrients. 2021 Oct 23;13(11):3736. doi: 10.3390/nu13113736. PMID: 34835992; PMCID: PMC8622458.
Radziszewska M, Smarkusz-Zarzecka J, Ostrowska L, Pogodziński D. Nutrition and Supplementation in Ulcerative Colitis. Nutrients. 2022 Jun 14;14(12):2469. doi: 10.3390/nu14122469. PMID: 35745199; PMCID: PMC9231317.
Sarbagili Shabat C, Scaldaferri F, Zittan E, Hirsch A, Mentella MC, Musca T, Cohen NA, Ron Y, Fliss Isakov N, Pfeffer J, Yaakov M, Fanali C, Turchini L, Masucci L, Quaranta G, Kolonimos N, Godneva A, Weinberger A, Kopylov U, Levine A, Maharshak N. Use of Faecal Transplantation with a Novel Diet for Mild to Moderate Active Ulcerative Colitis: The CRAFT UC Randomised Controlled Trial. J Crohns Colitis. 2022 Mar 14;16(3):369-378. doi: 10.1093/ecco-jcc/jjab165. PMID: 34514495; PMCID: PMC8919830.
Shen ZH, Zhu CX, Quan YS, Yang ZY, Wu S, Luo WW, Tan B, Wang XY. Relationship between intestinal microbiota and ulcerative colitis: Mechanisms and clinical application of probiotics and fecal microbiota transplantation. World J Gastroenterol. 2018 Jan 7;24(1):5-14. doi: 10.3748/wjg.v24.i1.5. PMID: 29358877; PMCID: PMC5757125.
Kaur L, Gordon M, Baines PA, Iheozor-Ejiofor Z, Sinopoulou V, Akobeng AK. Probiotics for induction of remission in ulcerative colitis. Cochrane Database Syst Rev. 2020 Mar 4;3(3):CD005573. doi: 10.1002/14651858.CD005573.pub3. PMID: 32128795; PMCID: PMC7059959.
Nishida A, Inoue R, Inatomi O, Bamba S, Naito Y, Andoh A. Gut microbiota in the pathogenesis of inflammatory bowel disease. Clin J Gastroenterol. 2018 Feb;11(1):1-10. doi: 10.1007/s12328-017-0813-5. Epub 2017 Dec 29. PMID: 29285689.
Jakubczyk D, Leszczyńska K, Górska S. The Effectiveness of Probiotics in the Treatment of Inflammatory Bowel Disease (IBD)-A Critical Review. Nutrients. 2020 Jul 2;12(7):1973. doi: 10.3390/nu12071973. PMID: 32630805; PMCID: PMC7400428.
Sandborn WJ, Feagan BG, D'Haens G, Wolf DC, Jovanovic I, Hanauer SB, Ghosh S, Petersen A, Hua SY, Lee JH, Charles L, Chitkara D, Usiskin K, Colombel JF, Laine L, Danese S; True North Study Group. Ozanimod as Induction and Maintenance Therapy for Ulcerative Colitis. N Engl J Med. 2021 Sep 30;385(14):1280-1291. doi: 10.1056/NEJMoa2033617. PMID: 34587385.
Antonelli EK, Del Sordo R, Morelli O, Villanacci V, Bassotti G. Update on ozanimod for ulcerative colitis. Drugs Today (Barc). 2022 Jul;58(7):351-367. doi: 10.1358/dot.2022.58.7.3408818. PMID: 35851870.
Paik J. Ozanimod: A Review in Ulcerative Colitis. Drugs. 2022 Aug;82(12):1303-1313. doi: 10.1007/s40265-022-01762-8. Epub 2022 Aug 22. Erratum in: Drugs. 2022 Sep 1;: PMID: 35994200; PMCID: PMC9499884.
Séverine Vermeire, Michael Chiorean, Julián Panés, Laurent Peyrin-Biroulet, Jinkun Zhang, Bruce E Sands, Krisztina Lazin, Preston Klassen, Snehal U Naik, Christopher H Cabell, William J Sandborn, Long-term Safety and Efficacy of Etrasimod for Ulcerative Colitis: Results from the Open-label Extension of the OASIS Study, Journal of Crohn's and Colitis, Volume 15, Issue 6, June 2021, Pages 950–959, https://doi.org/10.1093/ecco-jcc/jjab016
Danese S, Vermeire S, Zhou W, Pangan AL, Siffledeen J, Greenbloom S, Hébuterne X, D'Haens G, Nakase H, Panés J, Higgins PDR, Juillerat P, Lindsay JO, Loftus EV Jr, Sandborn WJ, Reinisch W, Chen MH, Sanchez Gonzalez Y, Huang B, Xie W, Liu J, Weinreich MA, Panaccione R. Upadacitinib as induction and maintenance therapy for moderately to severely active ulcerative colitis: results from three phase 3, multicentre, double-blind, randomised trials. Lancet. 2022 Jun 4;399(10341):2113-2128. doi: 10.1016/S0140-6736(22)00581-5. Epub 2022 May 26. Erratum in: Lancet. 2022 Sep 24;400(10357):996. PMID: 35644166.
Ghosh S, Sanchez Gonzalez Y, Zhou W, Clark R, Xie W, Louis E, Loftus EV, Panes J, Danese S. Upadacitinib Treatment Improves Symptoms of Bowel Urgency and Abdominal Pain, and Correlates With Quality of Life Improvements in Patients With Moderate to Severe Ulcerative Colitis. J Crohns Colitis. 2021 Dec 18;15(12):2022-2030. doi: 10.1093/ecco-jcc/jjab099. PMID: 34107013; PMCID: PMC8684481.
Rodríguez Toboso G, Rivera Vaquerizo PÁ, Martínez López MN, Blasco Colmenarejo MDM, Calvo Hernán F, Moreno Planas JM. Upadacitinib in refractory ulcerative colitis. Rev Esp Enferm Dig. 2022 Nov;114(11):686-688. doi: 10.17235/reed.2022.8870/2022. PMID: 35548867.
Lasa JS, Olivera PA, Danese S, Peyrin-Biroulet L. Efficacy and safety of biologics and small molecule drugs for patients with moderate-to-severe ulcerative colitis: a systematic review and network meta-analysis. Lancet Gastroenterol Hepatol. 2022 Feb;7(2):161-170. doi: 10.1016/S2468-1253(21)00377-0. Epub 2021 Nov 29. PMID: 34856198.
Peyrin-Biroulet L, Hart A, Bossuyt P, Long M, Allez M, Juillerat P, Armuzzi A, Loftus EV Jr, Ostad-Saffari E, Scalori A, Oh YS, Tole S, Chai A, Pulley J, Lacey S, Sandborn WJ; HICKORY Study Group. Etrolizumab as induction and maintenance therapy for ulcerative colitis in patients previously treated with tumour necrosis factor inhibitors (HICKORY): a phase 3, randomised, controlled trial. Lancet Gastroenterol Hepatol. 2022 Feb;7(2):128-140. doi: 10.1016/S2468-1253(21)00298-3. Epub 2021 Nov 17. PMID: 34798039.
Sandborn WJ, Cyrille M, Hansen MB, Feagan BG, Loftus EV Jr, Rogler G, Vermeire S, Cruz ML, Yang J, Boedigheimer MJ, Abuqayyas L, Evangelista CM, Sullivan BA, Reinisch W. Efficacy and Safety of Abrilumab in a Randomized, Placebo-Controlled Trial for Moderate-to-Severe Ulcerative Colitis. Gastroenterology. 2019 Mar;156(4):946-957.e18. doi: 10.1053/j.gastro.2018.11.035. Epub 2018 Nov 23. PMID: 30472236.
Hibi T, Motoya S, Ashida T, Sai S, Sameshima Y, Nakamura S, Maemoto A, Nii M, Sullivan BA, Gasser RA Jr, Suzuki Y. Efficacy and safety of abrilumab, an α4β7 integrin inhibitor, in Japanese patients with moderate-to-severe ulcerative colitis: a phase II study. Intest Res. 2019 Jul;17(3):375-386. doi: 10.5217/ir.2018.00141. Epub 2019 Feb 12. PMID: 30739435; PMCID: PMC6667363.
Noviello D, Mager R, Roda G, Borroni RG, Fiorino G, Vetrano S. The IL23-IL17 Immune Axis in the Treatment of Ulcerative Colitis: Successes, Defeats, and Ongoing Challenges. Front Immunol. 2021 May 17;12:611256. doi: 10.3389/fimmu.2021.611256. PMID: 34079536; PMCID: PMC8165319.
Sandborn WJ, Ferrante M, Bhandari BR, Berliba E, Feagan BG, Hibi T, Tuttle JL, Klekotka P, Friedrich S, Durante M, Morgan-Cox M, Laskowski J, Schmitz J, D'Haens GR. Efficacy and Safety of Mirikizumab in a Randomized Phase 2 Study of Patients With Ulcerative Colitis. Gastroenterology. 2020 Feb;158(3):537-549.e10. doi: 10.1053/j.gastro.2019.08.043. Epub 2019 Sep 4. PMID: 31493397.
Hanžel J, D'Haens GR. Anti-interleukin-23 agents for the treatment of ulcerative colitis. Expert Opin Biol Ther. 2020 Apr;20(4):399-406. doi: 10.1080/14712598.2020.1697227. Epub 2019 Nov 27. PMID: 31760827.
Matsuoka K. Fecal microbiota transplantation for ulcerative colitis. Immunol Med. 2021 Mar;44(1):30-34. doi: 10.1080/25785826.2020.1792040. Epub 2020 Jul 14. PMID: 32663072.
Paramsothy S, Nielsen S, Kamm MA, Deshpande NP, Faith JJ, Clemente JC, Paramsothy R, Walsh AJ, van den Bogaerde J, Samuel D, Leong RWL, Connor S, Ng W, Lin E, Borody TJ, Wilkins MR, Colombel JF, Mitchell HM, Kaakoush NO. Specific Bacteria and Metabolites Associated With Response to Fecal Microbiota Transplantation in Patients With Ulcerative Colitis. Gastroenterology. 2019 Apr;156(5):1440-1454.e2. doi: 10.1053/j.gastro.2018.12.001. Epub 2018 Dec 6. PMID: 30529583.
Haifer C, Paramsothy S, Kaakoush NO, Saikal A, Ghaly S, Yang T, Luu LDW, Borody TJ, Leong RW. Lyophilised oral faecal microbiota transplantation for ulcerative colitis (LOTUS): a randomised, double-blind, placebo-controlled trial. Lancet Gastroenterol Hepatol. 2022 Feb;7(2):141-151. doi: 10.1016/S2468-1253(21)00400-3. Epub 2021 Dec 2. PMID: 34863330.
Chaparro M, Garre A, Iborra M, Sierra-Ausín M, Barreiro-de Acosta M, Fernández-Clotet A, de Castro L, Boscá-Watts M, Casanova MJ, López-García A, Lorente R, Rodríguez C, Carbajo AY, Arroyo MT, Gutiérrez A, Hinojosa J, Martínez-Pérez T, Villoria A, Bermejo F, Busquets D, Camps B, Cañete F, Manceñido N, Monfort D, Navarro-Llavat M, Pérez-Calle JL, Ramos L, Rivero M, Angueira T, Camo Monterde P, Carpio D, García-de-la-Filia I, González-Muñoza C, Hernández L, Huguet JM, Morales VJ, Sicilia B, Vega P, Vera I, Zabana Y, Nos P, Suárez Álvarez P, Calviño-Suárez C, Ricart E, Hernández V, Mínguez M, Márquez L, Hervías Cruz D, Rubio Iturria S, Barrio J, Gargallo-Puyuelo C, Francés R, Hinojosa E, Del Moral M, Calvet X, Algaba A, Aldeguer X, Guardiola J, Mañosa M, Pajares R, Piqueras M, García-Bosch O, López Serrano P, Castro B, Lucendo AJ, Montoro M, Castro Ortiz E, Mesonero F, García-Planella E, Fuentes DA, Bort I, Delgado-Guillena P, Arias L, Iglesias A, Calvo M, Esteve M, Domènech E, Gisbert JP. Effectiveness and Safety of Ustekinumab in Ulcerative Colitis: Real-world Evidence from the ENEIDA Registry. J Crohns Colitis. 2021 Nov 8;15(11):1846-1851. doi: 10.1093/ecco-jcc/jjab070. PMID: 33860795; PMCID: PMC8083263.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Mikołaj Tomasik, Paweł Warzyszak, Róża Małek, Maria Milczek, Wojciech Żołyniak, Izabela Hawranik, Szymon Niski, Ziemowit Żaba, Aleksandra Lisowska, Mateusz Skrzypek
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 590
Number of citations: 0