What are the treatment options for colitis (inflammation of the colon)?

From the Guidelines

Colitis Treatment Options The primary goal of colitis treatment is to reduce inflammation and manage symptoms.

Treatment Approaches

• Mild to Moderate Colitis: can be treated with aminosalicylates such as mesalamine (Asacol) 2.4 g/day orally 1, or sulfasalazine (Azulfidine)
• Moderate to Severe Colitis: should be treated with oral corticosteroids such as prednisolone 40 mg daily 1, with a gradual taper over 6-8 weeks
• Severe Colitis: may require hospital admission for intensive treatment with intravenous steroids, such as methylprednisolone 60 mg each 24 h or hydrocortisone 100 mg four times daily 1
• Immunomodulators: such as azathioprine (Imuran) 50-100 mg orally once daily, or biologics like infliximab (Remicade) 5 mg/kg intravenously at weeks 0,2, and 6, may be considered for patients who do not respond to initial treatments 1
• Newer Therapies: such as vedolizumab, an integrin antagonist, and ozanimod, a small molecule therapy, may also be effective in treating colitis 1

Important Considerations

• It is essential to work closely with a healthcare provider to determine the best treatment plan, as the specific medication and dosage may vary depending on the individual's condition and medical history
• Treatment should be tailored to the individual's needs, taking into account the severity of symptoms, medical history, and potential side effects of medications
• Regular follow-up appointments and monitoring of symptoms and treatment response are crucial to ensure effective management of colitis.

From the FDA Drug Label

RENFLEXIS is a tumor necrosis factor (TNF) blocker indicated for: Ulcerative Colitis: • reducing signs and symptoms, inducing and maintaining clinical remission and mucosal healing, and eliminating corticosteroid use in adult patients with moderately to severely active disease who have had an inadequate response to conventional therapy. (1. 3) Pediatric Ulcerative Colitis: • reducing signs and symptoms and inducing and maintaining clinical remission in pediatric patients with moderately to severely active disease who have had an inadequate response to conventional therapy. (1. 4)

The treatment option for ulcerative colitis (a type of colitis) is infliximab (IV), which can help reduce signs and symptoms, induce and maintain clinical remission, and eliminate corticosteroid use in adult and pediatric patients with moderately to severely active disease who have had an inadequate response to conventional therapy 2.

• The recommended dosage for ulcerative colitis is 5 mg/kg at 0,2 and 6 weeks, then every 8 weeks.
• The recommended dosage for pediatric ulcerative colitis is 5 mg/kg at 0,2 and 6 weeks, then every 8 weeks.

From the Research

Treatment Options for Colitis

The treatment options for colitis, specifically ulcerative colitis (UC), depend on the severity and extent of mucosal inflammation. The goals of treatment are to improve quality of life, achieve steroid-free remission, and minimize the risk of cancer 3.

Medications Used in Treatment

• 5-aminosalicylates (5-ASA) are used as the first line of treatment for mild to moderate UC, and can be administered topically or orally 4, 5, 6.
• Corticosteroids are used to induce remission in moderate to severe UC, and can be administered orally or intravenously 4, 7, 5, 6.
• Immunomodulators such as azathioprine, 6-mercaptopurine, and methotrexate are used as steroid-sparing agents for maintenance therapy 7, 6.
• Biologic agents such as infliximab, anti-tumor necrosis factor-α (TNF-α) agents, anti-integrins, and Janus kinase inhibitors are used in the treatment of moderate to severe UC 7, 5.
• Calcineurin inhibitors such as cyclosporine and tacrolimus are used in patients who do not respond to other treatments 3, 6.

Surgical Options

• Surgery may be necessary in patients who do not respond to medical treatment, or who have complications such as toxic megacolon, colonic perforation, or severe colorectal bleeding 4, 3, 6.
• Proctocolectomy may be considered in patients with severe, chronic, refractory disease 4.

Disease Management

• The choice of treatment depends on the extent and severity of inflammation, as well as the course of the disease 5, 6.
• The Mayo scoring system is a commonly used index to assess disease severity and monitor patients during therapy 3.
• Close collaboration between gastroenterologist and surgeon is mandatory to ensure timely surgical intervention when needed 6.