Biologic Therapy for Ulcerative Colitis.

Five biologics are approved for the treatment of ulcerative colitis (UC): infliximab, adalimumab, golimumab, vedolizumab, and ustekinumab. These drugs have varying levels of efficacy and are recommended as first-line treatment of moderate to severe UC. There has been only 1 head-to-head trial comparing the efficacy of the biologics, adalimumab and vedolizumab, which has important implications for management. Therapeutic drug monitoring of biologics, especially anti-TNF alpha agents, may improve the long-term efficacy of these agents. The future of treatment may include personalization of medications, based on patient-specific and disease-specific characteristics as well as biomarkers, along with appropriate therapeutic drug monitoring.
Competing Interests: Disclosure A. Bhattacharya: none. M.T. Osterman: advisory board consultant for AbbVie, Elan, Janssen, Lycera, Merck, Pfizer, Takeda, and UCB; research grant support from UCB.
(Copyright © 2020 Elsevier Inc. All rights reserved.)