Can we move directly from 5-ASA to a biologic agent in ulcerative colitis?. (February 2018)

• Record Type: Journal Article
• Authors: Hindryckx, Pieter; Novak, Gregor
• Is Part Of: Best practice & research. Volume 32/33(2018)
• Page Start: 9
• Page End: 15
• Publication Date: 2018-02
• Subjects: Ulcerative colitis -- Biologic drugs -- Thiopurines -- Safety -- Mucosal healing -- Histological healing -- Treat-to-target; TNF tumor necrosis factor -- UC ulcerative colitis -- 5-ASA 5-aminosalicylic acid -- OR odds ratio; Gastroenterology -- Periodicals; Gastrointestinal system -- Diseases -- Periodicals; Gastrointestinal Diseases; Gastroenterology; Klinische geneeskunde; Gastro-enterologie; Gastroenterology; Gastrointestinal system -- Diseases; Periodicals; 616.33005
• DOI: 10.1016/j.bpg.2018.05.004
• Languages: English
• ISSNs: 1521-6918

Abstract

Abstract: European consensus guidelines and reimbursement policies position biologic drugs for ulcerative colitis (UC) as a third-line treatment, after failure of 5-aminosalicylic acid (5-ASA) and corticosteroids/thiopurines. While 5-ASA have a very favorable safety profile, (prolonged) use of corticosteroids and thiopurines is associated with potentially serious adverse events. The therapeutic landscape of UC is rapidly evolving and selective biologic drugs with improved safety are being introduced. The first biosimilars have entered the market, leading to improved cost-effectiveness of older biologic drugs. In addition, new insights have been gained in the importance of stringent therapeutic targets such as mucosal and histological healing to improve the long-term outcome of UC patients, and in the role of therapeutic drug monitoring and treatment optimization in this regard. In this manuscript we tackle the question of whether we should move directly from 5-ASA treatment to biologic drugs to offer better and/or safer care to UC patients.