Ulcerative colitis: modern treatment recommendations. Lecture. Part II

Ulcerative colitis (UC) is a chronic, incurable inflammatory bowel disease characterized by prolonged recurrent inflammation of the mucous membrane of the colon, varying in severity and extent, with mandatory involvement of the rectum in the inflammatory process. Choosing a treatment regimen for patients with UC is a complex task and, after diagnosis, requires a thorough analysis of the patient’s condition, assessment of symptom severity, the degree and activity of colitis, frequency of flare‑ups, evaluation of the effectiveness of previous treatments, prognosis of disease progression, and consideration of possible extraintestinal manifestations affecting other organs and systems of the body. This approach often necessitates a multidisciplinary team of specialists to take into account all aspects of the disease, assess the risk of complications, and determine the need for surgical intervention, which may result in patient disability. The material presented in the article‑lecture summarizes current data on medical treatment of adult patients with UC. It is important that clinicians are familiar with and use these guidelines within the framework of local regulations and also are willing to understand and respond to the individual needs and expectations of each individual patient. All groups of conventional therapy medications are approved for use in Ukraine, as well as a number of modern drugs for actual enhanced therapy of UC. Unfortunately, the limitation of resources of the health care system is a significant negative factor in decision‑making regarding the appointment of most modern, expensive drugs for advanced therapy of UC. At the same time, it is important to timely assess the risks, predict the likely course of the disease, timely assess the response to the prescribed treatment and take proactive actions to encourage the use of modern highly effective drugs of immunobiological therapy and small molecules approved in Ukraine to achieve and maintain a stable multilevel steroid‑free remission of the disease, restoration and preservation of a high level of social, mental and physical activity of patients, high indicators of quality of life and prevention of complications and disability in the long term. The recommendations given in the article are based on the results of numerous large‑scale international clinical studies, international and national consensus agreements. They should be used to make decisions about medical treatment, which is a most important part of the overall multidisciplinary treatment plan for patients with UC. Such a plan should also include psychological, nutritional and other non‑pharmacological interventions and recommendations.