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Medical approaches and future options in chronic active ulcerative colitis

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Abstract

Background

Immunosuppressive therapy employing purine analogues is the therapeutic mainstay in patients with chronic active ulcerative colitis. However, despite therapeutic optimization according to thiopurine-methyltransferase activity or red blood cell 6-thioguanine levels, a substantial proportion of patients does not tolerate azathioprine or 6-mercaptopurine or relapses during this treatment. In the latter multiple therapeutic regimens comprising 6-thioguanine, cyclosporin or tacrolimus, methotrexate, cyclophosphamide, infliximab, interferons, heparin, leukocyte apheresis, and various other regimens might be considered aiming at long-term remission. Many of these treatment forms have only been evaluated in small mostly uncontrolled trials.

Objective

In this review existing treatment modalities and future options for patients with chronic active ulcerative colitis will be discussed focusing on immunomodulating approaches.

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  1. II. Medizinische Klinik, Klinikum rechts der Isar, Technische Universität München, Munich, Germany

    J. T. Siveke

  2. Medizinische Poliklinik und Chirurgische Klinik und Poliklinik Innenstadt, Klinikum der Ludwig-Maximilians Universität, Pettenkoferstrasse 8a, 80336, Munich, Germany

    C. Folwaczny

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Siveke, J.T., Folwaczny, C. Medical approaches and future options in chronic active ulcerative colitis. Int J Colorectal Dis 19, 297–307 (2004). https://doi.org/10.1007/s00384-003-0569-x

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