title: Therapy of ulcerative colitis: state of the art.
abstract: OBJECTIVE
  Advances in conventional therapy, novel targets and therapeutic goals are the highlights of treatment for ulcerative colitis in the last year. There have also been disappointments. This review summarizes the highs and lows, with an emphasis on strategy as opposed to seeking the newest treatment option.
  
  
  RESULTS
  In conventional therapy, once daily therapy for 5-aminosalicylic acid is generally sufficient. Furthermore, a new 5-aminosalicylic acid (mesalamine MMX) has been released that effectively induces and maintains remission. There have been reappraisals of immunomodulators and further evaluation of (yes, now conventional!) infliximab for ulcerative colitis. Opportunistic infections, long-term outcomes and the burden of disease are being characterized. New therapeutic targets included an antibody against T cells (anti-CD3), but trials on visilizumab for acute severe colitis have been suspended. T-cell costimulation, phosphatidylcholine to promote barrier function, new anti-tumour necrosis factor agents, B-cell (anti-CD20) depletion and complementary therapies represent new therapeutic horizons. International agreement is needed on activity indices, definitions of remission, therapeutic goals (including mucosal healing) and outcomes that matter to patients, so that trials can be compared.
  
  
  CONCLUSIONS
  Advances will take time to alter mainstream practice, but 2007-2008 is the year of organized strategies, with European, American and British guidelines on ulcerative colitis published or in press. These should be the platform for better outcomes for patients.
authors.affiliation: Gastroenterology Unit, John Radcliffe Hospital, Oxford, UK.
authors.forename: Oliver
authors.initials: O
authors.lastname: Brain
authors.forename: Simon P L
authors.initials: SP
authors.lastname: Travis
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003082:Colectomy; D003093:Colitis, Ulcerative / Q000150:complications / Q000473:pathology / Q000628:therapy*; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use
chemical_list: D000893:Anti-Inflammatory Agents; D005765:Gastrointestinal Agents; D007155:Immunologic Factors