Millie Long, MD, on Updates in the Management of Ulcerative Colitis

Dr Long reviews key points from her presentation from the AIBD regional meetings on new therapies for managing ulcerative colitis.

Millie Long, MD, is a professor of medicine, vice chief of education and director of the fellowship program in the Division of Gastroenterology and Hepatology at the University of North Carolina at Chapel Hill.

TRANSCRIPT

Hi, this is Millie Long from University of North Carolina, and I wanted to give you an update on a talk that I gave at Advances in IBD Regionals where I discussed the updated management of ulcerative colitis. And I think one of the most important aspects is that we have wonderful options for our patients now. We have a number of newly approved medications, and importantly, we also have new ways to risk stratify, and new ways to monitor our patients. And I think that's the key take home point, that there are a number of newly approved medications that are very effective in terms of treating inflammation. But each of these drugs really needs to be used in the right patient. And once it is initiated, the monitoring that is done is to monitor for not only improvement in symptoms, but also improvement in biomarkers, biological inflammation, things like fecal calprotectin or repeating a flexible sigmoidoscopy, for example, to assess for healing.

So we want to pair both the clinical symptom improvement with the biological improvement, and what we've found is that by healing the bowel, it actually helps to prevent long-term disability for our patients, as well as to prevent complications that they really care about, things like hospitalization and surgery. Even the development of colorectal neoplasia has actually been linked to ongoing inflammatory activity. So if we can shut that off fully, it could actually help to reduce these poor outcomes in patients with ulcerative colitis.

When we think about new therapeutic mechanisms, just in the past two years, we've had a number of newly approved therapies including small molecules such as ozanimod, which is an S1P inhibitor, or upadacitinib which is a selective JAK inhibitor. So we have these small molecules coupled with the biologic options that we've had, and really help us to tailor therapy for our individual patients. We have therapies that are exceedingly safe. We have therapies that are exceedingly effective, and pairing the right patient with the right drug in a shared decision making format can help them to have the outcomes that they need. So please check out the Gastroenterology Learning Network website for more, and I look forward to seeing you hopefully at a future AIBD event.