Volume 148, Issue 5, Pages e3 (May 2015)

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Volume 148, Issue 5, Pages 1035-1058.e3 (May 2015) Clinical Practice Guidelines for the Medical Management of Nonhospitalized Ulcerative Colitis: The Toronto Consensus  Brian Bressler, John K. Marshall, Charles N. Bernstein, Alain Bitton, Jennifer Jones, Grigorios I. Leontiadis, Remo Panaccione, A. Hillary Steinhart, Francis Tse, Brian Feagan Waqqas Afif, Edmond-Jean Bernard, Mark Borgaonkar, Shane Devlin, Richard Fedorak, Geoffrey C. Nguyen, Robert Penner, Laurent Peyrin-Biroulet, Walter Reinisch, Cynthia H. Seow, Richmond Sy, Laura Targownik, Peter Thomson, Gert Van Assche, Chadwick Williams Brian Bressler, John K. Marshall, Charles N. Bernstein, Alain Bitton, Jennifer Jones, Grigorios I. Leontiadis, Remo Panaccione, A. Hillary Steinhart, Francis Tse, Brian Feagan Waqqas Afif, Edmond-Jean Bernard, Mark Borgaonkar, Shane Devlin, Richard Fedorak, Geoffrey C. Nguyen, Robert Penner, Laurent Peyrin-Biroulet, Walter Reinisch, Cynthia H. Seow, Richmond Sy, Laura Targownik, Peter Thomson, Gert Van Assche, Chadwick Williams  Gastroenterology  Volume 148, Issue 5, Pages 1035-1058.e3 (May 2015) DOI: 10.1053/j.gastro.2015.03.001 Copyright © 2015 AGA Institute Terms and Conditions

Figure 1 Guideline development process. Gastroenterology 2015 148, 1035-1058.e3DOI: (10.1053/j.gastro.2015.03.001) Copyright © 2015 AGA Institute Terms and Conditions

Figure 2 Meta-analysis of rectal corticosteroids versus 5-ASA controls for induction of symptomatic remission. Gastroenterology 2015 148, 1035-1058.e3DOI: (10.1053/j.gastro.2015.03.001) Copyright © 2015 AGA Institute Terms and Conditions

Figure 3 Meta-analysis of infliximab for induction of endoscopic remission (RR for no remission). From Ford AC, Sandborn WJ, Khan KJ, et al. Efficacy of biological therapies in inflammatory bowel disease: systematic review and meta-analysis. Am J Gastroenterol 2011;106:644–659.116 Copyright ©2011 Massachusetts Medical Society. Gastroenterology 2015 148, 1035-1058.e3DOI: (10.1053/j.gastro.2015.03.001) Copyright © 2015 AGA Institute Terms and Conditions

Figure 4 Meta-analysis of adalimumab for induction of complete remission. Gastroenterology 2015 148, 1035-1058.e3DOI: (10.1053/j.gastro.2015.03.001) Copyright © 2015 AGA Institute Terms and Conditions

Figure 5 Consensus-guided algorithm for the management of mild to moderate active UC. *Where available, oral MMX budesonide is an alternative. †The optimal time to assess for complete remission is uncertain but is between 4 and 12 months after initiation of therapy. Gastroenterology 2015 148, 1035-1058.e3DOI: (10.1053/j.gastro.2015.03.001) Copyright © 2015 AGA Institute Terms and Conditions

Figure 6 Consensus-guided algorithm for the management of moderate to severe active UC. *Not appropriate for patients who fail to respond to 5-ASA. †The role of dose intensification and therapeutic drug monitoring with vedolizumab therapy is uncertain. ‡The optimal time to assess for complete remission is uncertain but is between 4 and 12 months after initiation of therapy. Gastroenterology 2015 148, 1035-1058.e3DOI: (10.1053/j.gastro.2015.03.001) Copyright © 2015 AGA Institute Terms and Conditions

Figure 7 Consensus-guided algorithm for the management of corticosteroid-resistant/dependent UCa. a5-ASA is not appropriate for corticosteroid-resistant/dependent UC. †The optimal time to assess for complete remission is uncertain but is between 4 and 12 months after initiation of therapy. When complete remission is achieved, therapy should be continued. Gastroenterology 2015 148, 1035-1058.e3DOI: (10.1053/j.gastro.2015.03.001) Copyright © 2015 AGA Institute Terms and Conditions

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