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Targeted immune modulators for ulcerative colitis: effectiveness and value : final evidence report and meeting summary
Targeted immune modulators for ulcerative colitis: effectiveness and value : final evidence report and meeting summary
- Collection:
- Health Policy and Services Research
- Author(s):
- Ollendorf, Daniel A., author
Bloudek, Lisa, author
Carlson, Josh J., author
Pandey, Rajshree, author
Fazioli, Katherine, author
Chapman, Rick M., author
Bradt, Pamela, author
Pearson, Steven D., author - Contributor(s):
- Institute for Clinical and Economic Review, issuing body.
- Publication:
- [Boston, Massachusetts] : Institute for Clinical and Economic Review, October 16, 2020
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Colitis, Ulcerative -- drug therapy
Immune System -- drug effects
United States - Genre(s):
- Technical Report
- Abstract:
- Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) that affects the mucosa, the innermost lining of the intestinal wall in the large bowel (i.e., the colon and rectum). The disease causes long-lasting inflammation and ulcers in the digestive tract and is typically marked by periods of remission and recurrence of symptoms. Symptoms may include frequent diarrhea, sometimes with blood or pus, abdominal and/or rectal pain, weight loss, and fatigue. When the disease affects children, it can have a detrimental impact on growth, nutritional status, and psychosocial development. It is estimated that approximately 900,000 individuals in the United States (US) have UC. The economic burden of UC is significant, ranging between an estimated $15-32 billion per year. The management of UC in adults is dependent on the severity of symptoms. The goal of treatment is to induce a clinical response to treatment (as evidenced by a reduction of the disease’s key symptoms) or effect a complete remission of the symptoms during a short-term (six to 14 weeks) “induction” phase of treatment, and maintain response or remission via long-term “maintenance” therapy, often at a lower dose. Colectomy (surgical removal of the colon) may be considered in patients whose disease does not respond to maximal medical management. In patients with mild disease, local or topical use of aminosalicylates may induce and maintain remission. Once symptoms become moderate-to-severe, however, the use of oral or ileal/colonic preparations of budesonide as well as systemic corticosteroids is typically warranted.6 Those whose disease does not respond to or recurs despite systemic therapy are candidates for a number of targeted immune modulators (TIMs) to induce and/or maintain remission. These agents affect a number of different targets on the inflammatory cascade associated with UC and are summarized in Table ES1 on the following page.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
- Extent:
- 1 online resource (1 PDF file (various pagings))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 9918402188306676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918402188306676