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Review
. 2020 Aug 14;9(8):2646.
doi: 10.3390/jcm9082646.

Early Intervention in Ulcerative Colitis: Ready for Prime Time?

Virginia Solitano  1 , Ferdinando D'Amico  1   2 , Eirini Zacharopoulou  3 , Laurent Peyrin-Biroulet  2 , Silvio Danese  1   3
Affiliations
Review

Early Intervention in Ulcerative Colitis: Ready for Prime Time?

Virginia Solitano et al. J Clin Med. .

Abstract

Growing evidence shows that ulcerative colitis (UC) is a progressive disease similar to Crohn's disease (CD). The UC-related burden is often underestimated by physicians and a standard step-up therapeutic approach is preferred. However, in many patients with UC the disease activity is not adequately controlled by current management, leading to poor long-term prognosis. Data from both randomized controlled trials and real-world studies support early intervention in CD in order to prevent disease progression and irreversible bowel damage. Similarly, an early disease intervention during the so-called "window of opportunity" could lead to better outcomes in UC. Here, we summarize the literature evidence on early intervention in patients with UC, highlighting strengths and limitations of this approach.

Keywords: early intervention; top-down strategy; treat-to-target; ulcerative colitis; window of opportunity.

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Conflict of interest statement

V.S., F.D. and E.Z. declare no conflict of interest. L.P.-B. has served as a speaker, consultant and advisory board member for Merck, Abbvie, Janssen, Genentech, Mitsubishi, Ferring, Norgine, Tillots, Vifor, Hospira/Pfizer, Celltrion, Takeda, Biogaran, Boerhinger-Ingelheim, Lilly, HAC Pharma, Index Pharmaceuticals, Amgen, Sandoz, For- ward Pharma GmbH, Celgene, Biogen, Lycera, Samsung Bioepis, Theravance. S.D. has served as a speaker, consultant and advisory board member for Schering-Plough, AbbVie, MSD, UCB Pharma, Ferring, Cellerix, Millenium Takeda, Nycomed, Pharmacosmos, Actelion, Alphawasserman, Genentech, Grunenthal, Pfizer, Astra Zeneca, Novo Nordisk, Cosmo Pharmaceuticals, Vifor and Johnson & Johnson, Nikkiso Europe GMBH, Theravance.

Figures

Figure 1
Figure 1
Disease progression in patients with ulcerative colitis: towards “disease clearance”.
Figure 2
Figure 2
Combining strategies towards “disease clearance”.
See this image and copyright information in PMC

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