Ulcerative Colitis: The Complete Guide to Medical Management

Gary R. Lichtenstein, MD, FACP, FACG, AGAF

Chapter 34: Management of Steroid-Refractory and Steroid-Dependent Severe Ulcerative Colitis (continued)

Jesse A. Green, MD, FACG; Richard P. MacDermott, MD, FACG

MANAGEMENT OF STEROID-REFRACTORY AND STEROID-DEPENDENT SEVERE ULCERATIVE COLITIS Glucocorticosteroids continue to be an important therapy for patients with severe ulcerative colitis (UC).1,2 The onset of action of steroids in responders is rapid (usually within 48 hours), and they often are very effective, with response rates approaching 70% to 80%.1,2 However, steroids are associated with many common and potentially severe side effects. Furthermore, those patients who either fail to respond to steroids or who have lost their response to steroids3 pose a common…