Ulcerative Colitis: Management (NICE NG130)

NICE NG130 covers the management of ulcerative colitis including induction of remission, maintenance therapy, and the use of biologic agents.

Key Recommendations

• Mild-moderate UC: first-line 5-ASA (mesalazine) oral and rectal
• Moderate-severe UC: prednisolone for induction of remission
• Maintenance: 5-ASA for life in proctitis and left-sided disease; azathioprine for extensive disease
• Anti-TNF therapy (infliximab, adalimumab) for moderate-severe UC failing conventional therapy
• Vedolizumab or tofacitinib as alternatives to anti-TNF
• Annual colonoscopy for surveillance from 10 years post-diagnosis for extensive colitis
• Surgery (subtotal colectomy) for acute severe UC not responding to medical therapy