Five takeaways:
1. Joseph Feuerstein, MD, and his gastroenterology team at Beth Israel Deaconess Medical Center in Boston released the guidelines on AGA’s behalf.
2. The guidance focuses on immunomodulators, biologics and small molecules for inducing and maintaining remission in patients with moderate to severe ulcerative colitis. They also address decreasing the risk for colectomy patients with severe ulcerative colitis.
3. For adult outpatients with moderate to severe cases, the AGA said using infliximab, adalimumab, golimumab, vedolizumab, tofacitinib or ustekinumab is superior to providing no treatment at all.
4. Adult outpatients previously exposed to infliximab should be treated with ustekinumab or tofacitinib instead of vedolizumab or adalimumab.
5. The AGA recommends against using thiopurine monotherapy to induce remission in adult outpatients with moderate to severe ulcerative colitis. In these same patients, the society also does not recommend using methotrexate monotherapy to induce or maintain remission.
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