Danese Silvio, Fiorino Gionata, Peyrin-Biroulet Laurent
IBD Center, Department of Gastroenterology, Humanitas Clinical and Research Institute, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy.
IBD Center, Department of Gastroenterology, Humanitas Clinical and Research Institute, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy.
Clin Gastroenterol Hepatol. 2020 May;18(6):1280-1290.e1. doi: 10.1016/j.cgh.2020.01.017. Epub 2020 Jan 23.
Ulcerative colitis (UC) is a chronic, idiopathic inflammatory bowel disease (IBD) that affects the large intestine. Several therapeutic drug classes are available for the treatment of UC: salicylates, corticosteroids, thiopurines, calcineurin inhibitors, anti-tumor necrosis factor (TNF) agents, anti-adhesion molecules, and, more recently, small molecules directed against the Janus kinase (JAK) pathways, and ustekinumab (anti IL12/23). Other drugs are currently in development, and they will be probably available for UC patients in the near future. Several therapeutic algorithms have been proposed for the treatment of UC patients, yet these are predominantly based on expert opinions rather than high-quality evidence, mainly due to the lack of head-to-head trials, especially for monoclonal antibody and small molecule therapies. The optimal position of therapies in these algorithms remains unclear. Therefore, we conducted this review of the literature to provide an up-to-date overview of the available evidence on this topic.
溃疡性结肠炎（UC）是一种影响大肠的慢性、特发性炎症性肠病（IBD）。有几类治疗药物可用于治疗UC：水杨酸盐、皮质类固醇、硫唑嘌呤、钙调神经磷酸酶抑制剂、抗肿瘤坏死因子（TNF）药物、抗粘附分子，以及最近针对Janus激酶（JAK）通路的小分子药物和优特克单抗（抗IL12/23）。其他药物目前正在研发中，可能在不久的将来可供UC患者使用。已经提出了几种治疗UC患者的治疗方案，但这些方案主要基于专家意见而非高质量证据，主要原因是缺乏头对头试验，特别是对于单克隆抗体和小分子疗法。这些方案中各种疗法的最佳位置仍不明确。因此，我们进行了这项文献综述，以提供关于该主题的现有证据的最新概述。
