UEG's content platform for gastroenterology education bringing recordings, courses, guidelines, and more together in one place.

Re-live UEG Week 2026 on Gutflix Gut Guide online What's new on Gutflix

Trending on Gutflix

Rate for better recommendations!

Your feedback helps us show you more of what you like and less of what you dislike!

More of this!

We will show you more similar content.

Not for me!

We won't suggest this again.

Bookmark!

Save this content for later!

New to myUEG? Create an account! Log In with myUEG account

UEG Poster

Standard Poster

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

ADHERENCE TO DIAGNOSTIC AND TREATMENT RECOMMENDATIONS FOR THE MANAGEMENT OF ACUTE SEVERE ULCERATIVE COLITIS: A PROSPECTIVE AND MULTINATIONAL STUDY

Iago Rodríguez-Lago 1, Matteo Frasson 2, Thomas Pinkey 3, Susan Blackwell 4, Krisztina Barbara Gecse 5, Christianne Johanna Buskens 6, Charles H. Knowles 7, Oded Zmora 8, Matthew James Brookes 9, Gionata Fiorino 10, Pilar Nos Mateu 11, Gaetano Gallo 12, Francesco Pata 13, Azmina Verjee 14, Salvo Leone 15, Gianluca Pellino 16, Javier P. Gisbert 17

Affiliations

1 Hospital Universitario de Galdakao, Bilbao, Spain

2 Hospital Universitario y Politécnico La Fe, Valencia, Spain

3 Queen Elizabeth Hospital- University of Birmingham, Birmingham, United Kingdom

4 Patient representative, Liverpool, United Kingdom

5 Amsterdam University Medical Center, Amsterdam, Netherlands

6 Academic Medical Center, Amsterdam, Netherlands

7 Queen Mary University of London- Blizard Institute Knowles, London, United Kingdom

8 Assaf Harofeh Medical Center, Zerifin, Israel

9 Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom

10 IRCCS Ospedale San Raffaele and Vita-Salute San Raffaele University, Milan, Italy

11 Hospital Universitario y Politécnico La Fe, Gastroenterology, Valencia, Spain

12 Sapienza University of Rome, Rome, Italy

13 Nicola Giannettasio Hospital, Corigliano-Rossano, Italy

14 Patient representative, London, United Kingdom

15 AMICI Italia, Associazione nazionale per le Malattie Infiammatorie Croniche dell'Intestino, Milan, Italy

16 Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy

17 Hospital Universitario de La Princesa - Instituto de Investigación Sanitaria Princesa - Universidad Autónoma de Madrid, Madrid, Spain

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Introduction

Acute severe ulcerative colitis (ASUC) is a serious, potentially life-threatening condition. Hospital admission and prompt medical therapy with intravenous steroids is crucial, but rescue medical therapy is frequently needed, and surgery is often required.

Aims & Methods

Our aim was to assess the adherence to main diagnostic and management recommendations within the MASC multinational study. MASC was a prospective, multinational cohort study, including all consecutive patients hospitalized for ASUC between February 2019-January 2020. The primary outcome was surgery during the first 90 days after admission. We used descriptive statistics to determine the proportion of patients fulfilling each diagnostic and treatment recommendation according to ECCO and AGA.

Results

A total of 823 patients from 123 centers in 32 countries in five continents were included (median age 39 years [IQR, 28-54], 56% male, 64% non-smokers; Table 1). Most cases (74%) had a previous diagnosis of ulcerative colitis, and around half (48%) with prior ASUC episodes. Upon admission, they were under 5-ASA therapy (60%), thiopurines (14%), or biologics (21%). They were mostly admitted to the Gastroenterology ward (74%). During the initial assessment, 112 patients (15%) did not have stool culture or C. difficile testing, and CMV was evaluated in 50% of cases. Endoscopic assessment was performed in 66% of patients, mainly by flexible rectosigmoidoscopy (74%).

Patient characteristics	Frequency N=823
Age at ASUC diagnosis, median (IQR)	39 years (28-54)
Gender, male, n (%)	463 (56%)
Smoking history, never, n (%)	528 (64%)
Previous UC diagnosis, n (%)	613 (74%)
Disease extension, n (%) E1 E2 E3	54 (7%) 298 (36%) 428 (52%)
Previous episodes of ASUC, n (%)	297 (48%)
Ward of admission, Gastroenterology, n (%)	612 (74%)
Treatment upon admission, n (%) Oral steroids Oral mesalazine Thiopurines Methotrexate Anti-TNF Vedolizumab Tofacitinib Calcineurin inhibitors	37 (6%) 367 (60%) 85 (14%) 8 (1.3%) 100 (16%) 31 (5%) 17 (3%) 5 (1%)

Regarding treatment, 3.4% of patients received exclusive parenteral nutrition, 70% low molecular weight heparin, and 42% prophylactic antibiotics. Steroids were started after a median of 0 days (IQR, 0-1), mostly with methylprednisolone or hydrocortisone (64%), 26% with other steroids, and 7% were managed without steroids. Infliximab was started in 159 patients (19%) after a median of 6 days (IQR, 4-8) after starting steroids, with 27% after >7 days. Most of the patients (93%) had some type of tuberculosis screening done prior to infliximab. Twenty-eight patients (3.4%) started cyclosporine. Thirty-two patients (4%) received other rescue therapy different from infliximab or cyclosporin. Colectomy was performed in 25 patients (3%).

Conclusion

The diagnostic and medical management of ASUC remains heterogeneous and different from current recommendations. This context demands more evidence and consensus on the best management of ASUC.

Conference

UEG Week Vienna 2024

Topics

IBD

Submission format

Abstract

Session

Disease evolution of IBD (Posters)

Citation

United European Gastroenterology Journal 2024; 12 (Supplement 8)

Published

2024

More Like This:

Acute Severe Ulcerative Colitis

Haluk Tarik Kani

INFLIXIMAB TREATMENT STRATEGIES IN ACUTE SEVERE ULCERATIVE COLITIS: A PROSPECTIVE, MULTINATIONAL STUDY

Gionata Fiorino

MANAGEMENT OF ACUTE SEVERE COLITIS IN CROHN'S DISEASE

Ikram Errabih

ACUTE SEVERE ULCERATIVE COLITIS: ULCERATIVE COLITIS VERSUS CROHN’S DISEASE

Sarra Laabidi

EARLY MONITORING TREATMENT RESPONSE IN ULCERATIVE COLITIS: A MULTICENTER STUDY

Federica Furfaro

DEFINING DIAGNOSTIC ULTRASONOGRAPHIC PARAMETERS IN ULCERATIVE COLITIS: A LONGITUDINAL PROSPECTIVE MULTICENTER STUDY

Federica Furfaro

UEG Online Course

accredited

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.