We would like to thank our colleagues for their interest in our recent article.4 They are correct in their assertion that there was a period (1999–2001) when ciclosporin was the sole salvage agent available. As indicated in the paper, there was also an 18-month period at the conclusion of the study when infliximab was the only salvage agent used. Treatment allocation was patient-led and based upon an informed decision after detailed discussion with one of two IBD specialists at our centre. This included details of previous published studies and the centre's own experience. This approach is recommended in the Laharie study (page 1914).3 The consistency of the clinical protocols and decision-making inherent to a single-centre study design were presented as strengths of the study. The study was designed to test the two salvage agents with all other variables remaining the same during the study period. In addition, we believe this study has a high degree of external validity due to the utilisation of standardised treatment algorithms that were consistently applied to a patient cohort that is typical of those encountered in larger IBD centres. The path to colectomy is a unique journey for each ulcerative colitis-affected patient who undergoes this procedure. The timing of surgery is influenced by many variables, including obtaining informed consent. We disagree that this end point is ‘subjective and predetermined’ as consistent age-appropriate criteria were applied to patients when this clinical decision was made, as in previously published studies.4 Indeed, previous salvage therapy was not a variable considered in the making of this clinically important decision. Colectomy is a tangible, objective outcome that is reflective of the disease burden either acutely or cumulatively in the case of refractory disease. The authors’ declarations of personal and financial interests are unchanged from those in the original article.2