000			01937cam a2200193 4500500
005			20260329001956.0
041			_afre
042			_adc
100	1	0	_aCalméjane, Louis _eauthor
700	1	0	_aLaharie, David _eauthor
700	1	0	_aKirchgesner, Julien _eauthor
700	1	0	_aUzzan, Mathieu _eauthor
245	0	0	_aNovel medical strategies in acute severe ulcerative colitis
260			_c2024.
500			_a61
520			_aAcute severe ulcerative colitis occurs in up to 25% of patients with ulcerative colitis (UC). Therapeutic approaches have evolved in recent years with an increase in the use of biotherapies and in the number of treatments approved for moderate-to-severe UC. In this review, we summarize the latest evidence regarding short- and long-term medical strategies for severe acute colitis. In addition to standard care procedures—such as venous thromboembolism (VTE) prophylaxis, screening for triggers and aggravating factors, and close monitoring—the first-line treatment for severe acute colitis remains intravenous corticosteroids. Second-line therapies include infliximab and ciclosporin, which have similar short- and long-term colectomy rates. Pre-treatment exposure is key to guiding the choice of short- and long-term therapies in the context of severe acute colitis: In patients exposed to anti-TNF, calcineurin inhibitors may be preferred as a bridge therapy to vedolizumab or ustekinumab. Increasing evidence also supports the use of tofacitinib and anti-JAK in severe acute colitis. Finally, we will present future therapeutic perspectives, including novel combination therapies. A visual abstract summarizing these medical strategies is provided with this review.
786	0		_nHépato-Gastro & Oncologie Digestive | 31 | 3 | 2024-03-01 | p. 333-341 | 2115-3310
856	4	1	_uhttps://stm.cairn.info/journal-hepato-gastro-oncologie-digestive-2024-3-page-333?lang=en&redirect-ssocas=7080
999			_c1810425 _d1810425