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VIDEO: How to identify, manage patients with high-risk ulcerative colitis
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SAN ANTONIO — In this video from the American College of Gastroenterology Annual Meeting, David T. Rubin, MD, section chief of Gastroenterology, Hepatology and Nutrition, and co-director of the Digestive Diseases Center at the University of Chicago Medicine, discusses his presentation on identifying and managing patients with high-risk ulcerative colitis.
Indications of high-risk ulcerative colitis include more extensive disease, severe ulcerations on endoscopy, low albumin, low hemoglobin and being diagnosed at an early age, according to Rubin.
“The importance of knowing who is high risk has to do with your choices of treatment and your understanding of their prognosis in terms of their risk for colectomy or other adverse outcomes,” he said. “After you identify who they may be, we have to focus on treatments.”
Rubin further discussed strategies for selecting therapies to treat outpatients and patients who require hospitalization. In the outpatient setting, he emphasized the need to achieve remission with induction therapy, and then to use induction therapy to help select the appropriate maintenance therapy. In the hospital setting, Rubin outlined treatment options for patients who do not significantly improve after receiving IV steroids for 3 to 5 days, including infliximab (Remicade, Janssen), cyclosporine and surgery.
“I went through all of this with the audience and ended with an emphasis on remembering that surgery is a very nice option for some of these patients and that medical therapy in patients older than 50 actually has a higher risk of adverse events, including mortality, than elective surgery,” he said.
Reference:
Rubin D. High-Risk Ulcerative Colitis – Where Do We Start? Presented at: American College of Gastroenterology Annual Meeting; Oct. 25-30, 2019; San Antonio.
Disclosure: Rubin reports serving as a consultant for AbbVie, Abgenomics, Allergan, Inc., Arena Pharmaceuticals, Biomica, Bristol-Myers Squibb, Dizal Pharmaceuticals, Eli Lilly and Company, Ferring Pharmaceuticals, Inc., Genentech/Roche, Janssen Pharmaceuticals, Medtronic, Merck, Napo Pharmaceuticals, Pfizer, Shire, Takeda and Target PharmaSolutions, Inc., and on the board of trustees for the American College of Gastroenterology. He also reports being a co-founder of GoDuRn LLC, co-founder and CFO of Cornerstones Health, Inc., and receives grant/research support from AbbVie, Genentech/Roche, Janssen Pharmaceuticals, Prometheus Laboratories, Shire and Takeda.