2019 Management of Ulcerative Colitis: Where, When, Who, and What Now?

Ulcerative colitis (UC) is a progressive disease whose clinical, functional, and psychosocial impact can be comparable to that of Crohn's disease (CD). While the management of UC has for some time focused on simple control of symptoms, strategies for managing UC have progressed, with treatment goals shifting from resolution of symptoms to full control of the disease, with a final aim of halting or preventing disease progression. Management strategies have shifted from a step-up to a top-down approach to achieve these goals, which include mucosal healing, prevention of complications, surgery, and disability, and restoration of quality of life. This means that immunosuppressants and/or biologics are used earlier during the course of the disease; however, it leads to challenges for clinicians in identifying which patients will benefit from early intervention and which will derive minimal benefit.

The American Gastroenterology Association (AGA) Care Pathways provide practical tools to help providers risk-stratify their patients with inflammatory bowel disease (IBD) into those with low or moderate/high-risk disease. This stratification helps identify the most appropriate therapy for each patient that will lead to low disease activity or endoscopic remission. Unfortunately, several gaps have been noted in these areas. Clinicians are not appropriately using biologic agents for the treatment of UC and personalized plans such as the UC Care Pathway are often underutilized.

In this CME Outfitters enduring activity, expert faculty will discuss risk stratification in patients with UC, incorporation of biologies into personalized treatment plans, and integrating the Clinical Care Pathway and real-world data into treatment algorithms.