Optimizing 5-aminosalicylate for moderate ulcerative colitis: expert recommendations from the Asia-Pacific, Middle East, and Africa Inflammatory Bowel Disease Coalition
The lack of clear definition and classification for “moderate ulcerative colitis (UC)” creates ambiguity regarding the suitability of step-up versus top-down treatment approaches. In this paper, experts address crucial gaps in assessing and managing moderate UC. The Asia-Pacific, Middle East, and Af...
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| Format: | Article |
| Language: | English |
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Korean Association for the Study of Intestinal Diseases
2025-01-01
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| Series: | Intestinal Research |
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| Online Access: | http://irjournal.org/upload/pdf/ir-2024-00089.pdf |
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| author | Filiz Akyüz Yoon Kyo An Jakob Begun Satimai Aniwan Huu Hoang Bui Webber Chan Chang Hwan Choi Nazeer Chopdat Susan J Connor Devendra Desai Emma Flanagan Taku Kobayashi Allen Yu-Hung Lai Rupert W Leong Alex Hwong-Ruey Leow Wai Keung Leung Julajak Limsrivilai Virly Nanda Muzellina Kiran Peddi Zhihua Ran Shu Chen Wei Jose Sollano Michelle Mui Hian Teo Kaichun Wu Byong Duk Ye Choon Jin Ooi |
| author_facet | Filiz Akyüz Yoon Kyo An Jakob Begun Satimai Aniwan Huu Hoang Bui Webber Chan Chang Hwan Choi Nazeer Chopdat Susan J Connor Devendra Desai Emma Flanagan Taku Kobayashi Allen Yu-Hung Lai Rupert W Leong Alex Hwong-Ruey Leow Wai Keung Leung Julajak Limsrivilai Virly Nanda Muzellina Kiran Peddi Zhihua Ran Shu Chen Wei Jose Sollano Michelle Mui Hian Teo Kaichun Wu Byong Duk Ye Choon Jin Ooi |
| author_sort | Filiz Akyüz |
| collection | DOAJ |
| description | The lack of clear definition and classification for “moderate ulcerative colitis (UC)” creates ambiguity regarding the suitability of step-up versus top-down treatment approaches. In this paper, experts address crucial gaps in assessing and managing moderate UC. The Asia-Pacific, Middle East, and Africa Inflammatory Bowel Disease Coalition comprised 24 experts who convened to share, discuss and vote electronically on management recommendations for moderate UC. Experts emphasized that the goal of treating UC is to attain clinical, biomarker, and endoscopic remission using cost-effective strategies such as 5-aminosalicylates (5-ASAs), well-tolerated therapy that can be optimized to improve outcomes. Experts agreed that 5-ASA therapy could be optimized by maximizing dosage (4 g/day for induction of remission), combining oral and topical administration, extending treatment duration beyond 8 weeks, and enhancing patient adherence through personalized counselling and reduced pill burden. Treatment escalation should ideally be reserved for patients with predictors of aggressive disease or those who do not respond to 5-ASA optimization. Premature treatment escalation to advanced therapies (including biologics and oral small molecules) may have long-term health and financial consequences. This paper provides consensus-based expert recommendations and a treatment algorithm, based on current evidence and practices, to assist decision-making in real-world settings. |
| format | Article |
| id | doaj-art-b5fdd3a848d24112b0c88ec9495d9718 |
| institution | OA Journals |
| issn | 1598-9100 2288-1956 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Korean Association for the Study of Intestinal Diseases |
| record_format | Article |
| series | Intestinal Research |
| spelling | doaj-art-b5fdd3a848d24112b0c88ec9495d97182025-08-20T01:52:15ZengKorean Association for the Study of Intestinal DiseasesIntestinal Research1598-91002288-19562025-01-01231375510.5217/ir.2024.000891087Optimizing 5-aminosalicylate for moderate ulcerative colitis: expert recommendations from the Asia-Pacific, Middle East, and Africa Inflammatory Bowel Disease CoalitionFiliz Akyüz0Yoon Kyo An1Jakob Begun2Satimai Aniwan3Huu Hoang Bui4Webber Chan5Chang Hwan Choi6Nazeer Chopdat7Susan J Connor8Devendra Desai9Emma Flanagan10Taku Kobayashi11Allen Yu-Hung Lai12Rupert W Leong13Alex Hwong-Ruey Leow14Wai Keung Leung15Julajak Limsrivilai16Virly Nanda Muzellina17Kiran Peddi18Zhihua Ran19Shu Chen Wei20Jose Sollano21Michelle Mui Hian Teo22Kaichun Wu23Byong Duk Ye24Choon Jin Ooi25 Department of Gastroenterology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Türkiye Department of Gastroenterology, Mater Hospital Brisbane, Brisbane, Australia Department of Gastroenterology, Mater Hospital Brisbane, Brisbane, Australia Division of Gastroenterology, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand Department of Gastroenterology, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam The Gastroenterology Group, Gleneagles Hospital, Singapore Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea Department of Gastroenterology, Baragwanath Hospital, University of the Witwatersrand, Johannesburg, South Africa Department of Gastroenterology, Liverpool Hospital, Sydney, Australia Division of Medical Gastroenterology, P. D. Hinduja Hospital, Mumbai, India Department of Gastroenterology, St. Vincent’s Hospital, Melbourne, Australia Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, Japan Global Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan Department of Gastroenterology, Concord Hospital, Sydney, Australia Pantai Hospital Kuala Lumpur, Kuala Lumpur, Malaysia Department of Medicine, University of Hong Kong, Hong Kong, China Deparment of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand Gastrointestinal Endoscopy Center, Cipto Mangunkusumo General Hospital, Jakarta, Indonesia Department of Gastroenterology, Yashoda Hospital, Hyderabad, India Department of Gastroenterology, Zhoupu Hospital, Shanghai University of Medicine & Health Sciences, Shanghai, China Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan Faculty of Medicine and Surgery, University of Santo Tomas, Manila, Philippines Ferring Pharmaceuticals, Singapore Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi’an, China Department of Gastroenterology and Inflammatory Bowel Disease Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Duke-NUS Medical School, SingaporeThe lack of clear definition and classification for “moderate ulcerative colitis (UC)” creates ambiguity regarding the suitability of step-up versus top-down treatment approaches. In this paper, experts address crucial gaps in assessing and managing moderate UC. The Asia-Pacific, Middle East, and Africa Inflammatory Bowel Disease Coalition comprised 24 experts who convened to share, discuss and vote electronically on management recommendations for moderate UC. Experts emphasized that the goal of treating UC is to attain clinical, biomarker, and endoscopic remission using cost-effective strategies such as 5-aminosalicylates (5-ASAs), well-tolerated therapy that can be optimized to improve outcomes. Experts agreed that 5-ASA therapy could be optimized by maximizing dosage (4 g/day for induction of remission), combining oral and topical administration, extending treatment duration beyond 8 weeks, and enhancing patient adherence through personalized counselling and reduced pill burden. Treatment escalation should ideally be reserved for patients with predictors of aggressive disease or those who do not respond to 5-ASA optimization. Premature treatment escalation to advanced therapies (including biologics and oral small molecules) may have long-term health and financial consequences. This paper provides consensus-based expert recommendations and a treatment algorithm, based on current evidence and practices, to assist decision-making in real-world settings.http://irjournal.org/upload/pdf/ir-2024-00089.pdfulcerative colitis5-aminosalicylatestreatment optimizationinflammatory bowel diseases |
| spellingShingle | Filiz Akyüz Yoon Kyo An Jakob Begun Satimai Aniwan Huu Hoang Bui Webber Chan Chang Hwan Choi Nazeer Chopdat Susan J Connor Devendra Desai Emma Flanagan Taku Kobayashi Allen Yu-Hung Lai Rupert W Leong Alex Hwong-Ruey Leow Wai Keung Leung Julajak Limsrivilai Virly Nanda Muzellina Kiran Peddi Zhihua Ran Shu Chen Wei Jose Sollano Michelle Mui Hian Teo Kaichun Wu Byong Duk Ye Choon Jin Ooi Optimizing 5-aminosalicylate for moderate ulcerative colitis: expert recommendations from the Asia-Pacific, Middle East, and Africa Inflammatory Bowel Disease Coalition Intestinal Research ulcerative colitis 5-aminosalicylates treatment optimization inflammatory bowel diseases |
| title | Optimizing 5-aminosalicylate for moderate ulcerative colitis: expert recommendations from the Asia-Pacific, Middle East, and Africa Inflammatory Bowel Disease Coalition |
| title_full | Optimizing 5-aminosalicylate for moderate ulcerative colitis: expert recommendations from the Asia-Pacific, Middle East, and Africa Inflammatory Bowel Disease Coalition |
| title_fullStr | Optimizing 5-aminosalicylate for moderate ulcerative colitis: expert recommendations from the Asia-Pacific, Middle East, and Africa Inflammatory Bowel Disease Coalition |
| title_full_unstemmed | Optimizing 5-aminosalicylate for moderate ulcerative colitis: expert recommendations from the Asia-Pacific, Middle East, and Africa Inflammatory Bowel Disease Coalition |
| title_short | Optimizing 5-aminosalicylate for moderate ulcerative colitis: expert recommendations from the Asia-Pacific, Middle East, and Africa Inflammatory Bowel Disease Coalition |
| title_sort | optimizing 5 aminosalicylate for moderate ulcerative colitis expert recommendations from the asia pacific middle east and africa inflammatory bowel disease coalition |
| topic | ulcerative colitis 5-aminosalicylates treatment optimization inflammatory bowel diseases |
| url | http://irjournal.org/upload/pdf/ir-2024-00089.pdf |
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