title: [Biological agents in ulcerative colitis. When to prescribe].
abstract: Biological agents are effective both in inducing and in maintaining remission in patients with ulcerative colitis. These drugs began to be used later in ulcerative colitis than in Crohn's disease because, in addition to the possibility of surgery, other therapeutic options such as cyclosporine were available for the latter disease. Most studies and data concern infliximab, the only currently approved biological agent; however, the less than entirely satisfactory results of the first studies could also have delayed the use of this drug in Crohn's disease. Due to the results of a Scandinavian study, infliximab was initially indicated in severe, corticosteroid-resistant ulcerative colitis. Subsequently, numerous open series and observational studies have confirmed the efficacy of this drug in this subgroup of patients. However, after several years of using infliximab in colitis, clinicians are increasingly aware that its efficacy is greater in patients with corticosteroid-dependent, moderate-severe disease not requiring hospitalization than in hospitalized patients with severe disease. In the last few years, data have emerged to support the efficacy of infliximab in certain areas of ulcerative colitis refractory to other therapies, such as pediatric patients and reservoiritis. Recently, new data on another biological agent (adalimumab) in this disease have been published. The evidence indicates that this drug will soon be indicated in the treatment of ulcerative colitis.
authors.affiliation: Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Aparato Digestivo, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, España.  manubarreiro@hotmail.com
authors.forename: Manuel
authors.initials: M
authors.lastname: Barreiro-de Acosta
mesh_terms: D000068879:Adalimumab / Q000627:therapeutic use; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D001688:Biological Products / Q000627:therapeutic use; D002648:Child; D003082:Colectomy / Q000706:statistics & numerical data; D003093:Colitis, Ulcerative / Q000188:drug therapy* / Q000601:surgery; D003131:Combined Modality Therapy; D016572:Cyclosporine / Q000627:therapeutic use; D004311:Double-Blind Method; D004351:Drug Resistance; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D000069285:Infliximab / Q000627:therapeutic use*; D015337:Multicenter Studies as Topic; D064887:Observational Studies as Topic; D011349:Proctitis / Q000188:drug therapy; D016032:Randomized Controlled Trials as Topic; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000305:Adrenal Cortex Hormones; D001688:Biological Products; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha; D016572:Cyclosporine; D000069285:Infliximab; D000068879:Adalimumab
keywords: Adalimumab; Colitis ulcerosa; Corticodependencia; Corticorresistencia; Corticosteroid dependence; Corticosteroid resistance; Infliximab; Ulcerative colitis