Management of Ulcerative Colitis: Putting Patients at the Centre

Abstract

The treatment landscape of ulcerative colitis (UC) is changing, with new treatment options becoming available and insights into disease management demonstrating the importance of a patient-centric approach. Induction and maintenance of long-term remission are important treatment goals. However, some of the current treatment options often have limited efficacy, which may be coupled with an unfavourable safety profile, such as an increased risk of infection. A multiphase approach to disease management, which includes induction and maintenance of remission through close monitoring, is a viable clinical strategy. Selecting an appropriate first-line therapy is a crucial part of this strategy, as options are sometimes limited for patients who have failed anti-tumour necrosis factor (TNF) therapy. The integrin antagonist, vedolizumab, has demonstrated effective induction and maintenance of clinical remission in both anti-TNF-naïve and anti-TNF-failure patients, with no increase in infection risks. Therefore, vedolizumab should be considered for inducing and maintaining remission as part of a patient-centric disease management programme. The development of simplified monitoring systems that provide an indication of endoscopic activity will also aid patients in taking charge of their disease management. In conclusion, putting our patients at the centre of a proactive model of disease management can help prevent complications in the long-term, and selecting suitable first-line therapies is an important step in this process.