title: Physician Perspectives on Unresolved Issues in the Management of Ulcerative Colitis: The UC Horizons Project.
abstract: BACKGROUND
  There is still uncertainty about what constitutes the best therapeutic practice in ulcerative colitis (UC).
  
  
  OBJECTIVE
  The purpose of the "UC Horizons Project" was to raise a series of questions regarding the management of UC to provide responses based on the best scientific evidence available.
  
  
  METHODS
  The 11 members of the scientific committee prepared draft answers to the 10 questions from available evidence after a literature search. A total of 48 Spanish gastroenterology specialists nationwide participated in the project. The national meeting discussed the 10 issues in working groups and reached consensus regarding the recommendations by anonymous, interactive vote following the Delphi methodology. Final answers were developed, based on evidence and clinical experience of the participants.
  
  
  RESULTS
  All the recommendations achieved a high level of agreement in the plenary vote, although the quality of the evidence was markedly heterogeneous. The lowest percentage of agreement corresponded to the questions with the weakest level of evidence, highlighting the necessity of conducting further studies in these areas. The recommendations focused on (1) aminosalicylates therapy (regarding dose and appropriateness of coadministration with thiopurines), (2) corticosteroid therapy (regarding dose and route of administration), (3) thiopurine treatment (regarding indications and possibility of withdrawal), (4) anti-tumor necrosis factor therapy (regarding appropriateness of combination with thiopurines, intensification, or discontinuation of treatment), and (5) colorectal cancer (regarding risk and time trends).
  
  
  CONCLUSIONS
  The UC Horizons Project raised a series of eminently practical questions about the management of UC and provided responses based on the best scientific evidence available.
authors.affiliation: *Department of Gastroenterology, Hospital Universitario de La Princesa, Instituto de Investigacion Sanitaria Princesa (IIS-IP), Madrid, and Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas (CIBEREHD), Spain; †Department of Gastroenterology, Hospital Clinico Universitario, Santiago de Compostela, Spain; ‡Department of Gastroenterology, Hospital Universitari Mutua de Terrassa, Barcelona, and CIBEREHD, Spain; §Department of Gastroenterology, Instituto Maimonides de Investigacion Biomedica de Cordoba (IMIBIC), Hospital Universitario Reina Sofia, Hospital Universitario Reina Sofia, Cordoba, Spain; ‖Department of Gastroenterology, Hospital Clinico Universitario Lozano Blesa, Zaragoza, and CIBEREHD, Spain; ¶Department of Gastroenterology, Hospital Universitario de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; **Department of Gastroenterology, Hospital de Manises, Valencia, Spain; ††Department of Gastroenterology, Hospital Universitario La Paz, Madrid, Spain; ‡‡Department of Gastroenterology, Hospital Clínico Universitario, Universitat de Valencia, Valencia, Spain; §§Department of Gastroenterology, Hospital Clinico San Carlos and Instituto de Investigacion del Hospital Clinico San Carlos (IdISSC), Madrid, Spain; and ‖‖Department of Gastroenterology and Hepatology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
authors.forename: Javier P
authors.initials: JP
authors.lastname: Gisbert
authors.forename: Manuel
authors.initials: M
authors.lastname: Barreiro-de Acosta
authors.forename: María
authors.initials: M
authors.lastname: Esteve
authors.forename: Valle
authors.initials: V
authors.lastname: García-Sánchez
authors.forename: Fernando
authors.initials: F
authors.lastname: Gomollón
authors.forename: Jordi
authors.initials: J
authors.lastname: Guardiola
authors.forename: Joaquin
authors.initials: J
authors.lastname: Hinojosa
authors.forename: Maria-Dolores
authors.initials: MD
authors.lastname: Martín Arranz
authors.forename: Miguel
authors.initials: M
authors.lastname: Minguez
authors.forename: Carlos
authors.initials: C
authors.lastname: Taxonera
authors.forename: Isabel
authors.initials: I
authors.lastname: Vera
mesh_terms: D001291:Attitude of Health Personnel; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D032921:Consensus; D019468:Disease Management; D005762:Gastroenterology; D006801:Humans; D010820:Physicians; D017410:Practice Guidelines as Topic / Q000592:standards*; D012074:Remission Induction; D011795:Surveys and Questionnaires