2 days Ago By George Citroner
Doctors released the first-ever “living” guideline for treating moderate-to-severe ulcerative colitis on Tuesday. Living guidelines differ from traditional treatment guidelines in that they are updated more quickly as new research findings and suitable treatments become available. Instead of being revised every few years, living guidelines are updated as soon as new information emerges, ensuring patients always have access to the most current, evidence-based treatment recommendations.
The new guideline published by the American Gastroenterological Association (AGA) shifts away from traditional step-by-step treatment approaches. It recommends that patients with moderate-to-severe ulcerative colitis start treatment immediately with advanced therapies, potentially shortening their path to relief. The AGA introduced an “efficacy buckets” system to make treatment selection more efficient, grouping drugs with similar effectiveness.
This approach aims to help clinicians select treatments based on their likelihood of inducing remission, regardless of how the drugs work. Shift in Treatment Approach For patients who haven’t previously received advanced therapies, the guideline indicates that medications with high efficacy include infliximab, vedolizumab, ozanimod, etrasimod, upadacitinib, risankizumab, and guselkumab. For patients with prior exposure to advanced therapies, particularly those who have experienced tumor necrosis factor (TNF)-alpha antagonist failure—where the drug doesn’t offer sufficient symptom relief—the guideline states that the most effective medications are tofacitinib, upadacitinib, and ustekinumab.
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