title: Overview of biological therapy in ulcerative colitis: current and future directions.
abstract: The treatment of ulcerative colitis (UC) has changed over the last decade. It is extremely important to optimize the therapies which are available nowadays and commonly used in daily clinical practice, as well as to stimulate the search for more powerful drugs for the induction and maintenance of sustained and durable remission, thus preventing further complications. Therefore, it is mandatory to identify the patients' prognostic variables associated with an aggressive clinical course and to test the most potent therapies accordingly. To date, the conventional therapeutic approach based on corticosteroids, salicylates (sulfasalazine, 5-aminosalicylic acid) or immunosuppressive agents is commonly used as a first step to induce and to maintain remission. However, in recent years, knowledge of new pathogenetic mechanisms of ulcerative colitis have allowed us to find new therapeutic targets leading to the development of new treatments that directly target proinflammatory mediators, such as TNF-alpha, cytokines, membrane migration agents, cellular therapies. The aim of this review is to provide the most significant data regarding the therapeutic role of drugs in UC and to give an overview of biological and experimental drugs that will become available in the near future. In particular, we will analyse the role of these drugs in the treatment of acute flare and maintenance of UC, as well as its importance in mucosal healing and in treating patients at a high risk of relapse.
authors.affiliation: Department of Gastroenterology, Oncology-Surgery, L.Sacco University Hospital, Milan, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Furfaro
authors.affiliation: Department of Gastroenterology, Oncology-Surgery, L.Sacco University Hospital, Milan, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Bezzio
authors.affiliation: Department of Gastroenterology, Oncology-Surgery, L.Sacco University Hospital, Milan, Italy.
authors.forename: Sandro
authors.initials: S
authors.lastname: Ardizzone
authors.affiliation: Department of Gastroenterology, Oncology-Surgery, L.Sacco University Hospital, Milan, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Massari
authors.affiliation: Department of Gastroenterology, Oncology-Surgery, L.Sacco University Hospital, Milan, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: de Franchis
authors.affiliation: Department of Gastroenterology, Oncology-Surgery, L.Sacco University Hospital, Milan, Italy. giovanni.maconi@unimi.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Maconi
mesh_terms: D000818:Animals; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001688:Biological Products / Q000009:adverse effects / Q000627:therapeutic use*; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D005765:Gastrointestinal Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D012008:Recurrence; D012074:Remission Induction; D012307:Risk Factors; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors / Q000276:immunology
chemical_list: D000893:Anti-Inflammatory Agents; D001688:Biological Products; D005765:Gastrointestinal Agents; D014409:Tumor Necrosis Factor-alpha