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JCOM Abstract

J Clin Outcomes Manage 
2012 Nov;19(11):501-517
Therapeutic options in steroid-refractory acute severe ulcerative colitis
Blonski W, Mudireddy PR, Buchner AM, Lichtenstein GR

Abstract Objective: To review therapeutic options in patients with steroid-refractory severe ulcerative colitis (UC). Methods: Review of the literature. Results: UC is characterized by periods of active and inactive disease, a pattern observed in 80% to 90% of patients with this disease. About 15% to 25% of patients with UC will present with a severe attack at least once in their lifetime. Usual treatment for acute severe UC is intravenous corticosteroids, but about 30% to 40% of patients fail to respond to steroids. Patients presenting with severe corticosteroid-refractory disease can be treated medically with cyclosporine, infliximab, or tacrolimus or undergo emergent proctocolectomy. Conclusion: Currently there is no ideal treatment of choice in patients with severe steroid-refractory UC. Further studies are needed to determine the best treatment for these patients.

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