Recommendation ID
CG166/3
Question
Induction of remission for people with subacute ulcerative colitis that is refractory to systemic corticosteroids:- What are the benefits, risks and cost effectiveness of methotrexate, ciclosporin, tacrolimus, adalimumab and infliximab compared with each other and with placebo for induction of remission for people with subacute ulcerative colitis that is refractory to systemic corticosteroids?
Any explanatory notes
(if applicable)
Why this is important:- The best drug treatment for people with subacute ulcerative colitis whose condition fails to respond to treatment with oral prednisolone (a systemic corticosteroid) is unclear. Without effective treatment the condition may deteriorate, and may lead to the person requiring hospital admission for intravenous corticosteroid treatment or even surgery. It is common clinical practice to offer treatment with methotrexate or a calcineurin inhibitor (ciclosporin or tacrolimus), but high-quality evidence to guide clinicians is lacking. The use of infliximab in such cases was not recommended by NICE in technology appraisal guidance 140.This question should be investigated by a multicentre randomised, placebo-controlled trial in adults in secondary care. Outcomes should include patient-centred outcome measures.

Source guidance details

Comes from guidance
Ulcerative colitis: management
Number
CG166
Date issued
June 2013

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No  
Last Reviewed 15/07/2013