Gut 62:1642-1652 doi:10.1136/gutjnl-2012-303959
  • Recent advances in clinical practice

New therapeutic avenues in ulcerative colitis: thinking out of the box

  1. Jean-Frédéric Colombel3
  1. 1 Gastroenterology Service, Surgery Department, Hospital Beatriz Ângelo, Loures, Portugal
  2. 2 Department of Gastroenterology, IBD Center, Humanitas Clinical and Research Center, Milan, Italy
  3. 3The Dr Henry D Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai New York, New York, USA
  1. Correspondence to Professor Jean-Frédéric Colombel, The Dr Henry D Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY 10029, USA; jean-frederic.colombel{at}
  • Received 24 January 2013
  • Revised 15 March 2013
  • Accepted 20 March 2013


Ulcerative colitis (UC) is a chronic idiopathic inflammatory disease of the gastrointestinal tract that affects the mucosal lining of the colon. Recent epidemiological data show that its incidence and prevalence are increasing in many parts of the world, in parallel with altered lifestyles, improved access to health, improved sanitation and industrialisation rates. Current therapeutic strategies for treating UC have only been moderately successful. Despite major recent advances in inflammatory bowel disease therapeutic resources, a considerable proportion of patients are still refractory to conventional treatment. Less than half of all patients achieve long-term remission, many require colectomy, and the disease still has a major impact on patients’ lives. Moreover, recent data point to slightly raised mortality. While these outcomes could be partly improved by optimising current therapeutic strategies, they clearly highlight the need to develop new therapies. Currently, a number of promising and innovative therapeutic approaches are being explored, some of which will hopefully survive to reach the clinic. Until such a time arrives, it is important that a better understanding of the clinical particularities of the disease, an improved knowledge of the host-microbiome negative interactions and of the environmental factors beyond disease development is achieved to obtain the final and desired outcome: to provide better treatment and quality of life for patients with this disabling disease.