Literature Review: Ulcerative Colitis

Ulcerative colitis (UC) is a chronic inflammatory disease of unknown etiology and pathogenesis. The disease involves the large intestine, in which the lining of the colon becomes inflamed and develops tiny open sores, or ulcers, that produce pus and mucus. The combination of inflammation and ulceration can cause abdominal discomfort and frequent emptying of the colon. The most common types of UC include ulcerative proctitis, proctosigmoiditis, left-sided colitis, and pancolitis. The Crohn’s and Colitis Foundation of America estimates that UC may affect as many as 700,000 Americans with men and women equally affected. While most people are diagnosed in the their mid-30s, UC can occur at any age.

Treatment of UC usually involves either drug therapy or surgery. Pharmacological management of UC includes aminosalicylates, corticosteroids, immunomodulators, calcineurin inhibitors, biologic therapies, α-4 integrin inhibitors, antimicrobials, and antidiarrheals. For this literature review, First Report Managed Care focused on the safety and efficacy of the corticosteroid budesonide, which is available in oral, enema, and rectal foam formulations, and the investigational α-4 integrin inhibitor etrolizumab. Because patients with long-term UC are at greater risk of colorectal cancer (CRC), First Report Managed Care also identified a study that examined UC-associated CRC. This article provides an overview of these studies.