{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T21:37:39Z","timestamp":1785188259319,"version":"3.55.0"},"reference-count":71,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2023,6,22]],"date-time":"2023-06-22T00:00:00Z","timestamp":1687392000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Tillotts Pharma AG"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Although ulcerative colitis [UC] shares many common pathways and therapeutic options with Crohn\u2019s disease [CD], CD patients are four times more likely to undergo surgery 10 years into their disease in the biological era and are more likely to have extraintestinal manifestations than UC patients. Early treatment in CD has been demonstrated to modify the natural history of the disease and potentially delay surgery. Previous reviews on this topic have borrowed their evidence from CD to make UC-specific recommendations. This review highlights the emergence of UC-specific data from larger cohort studies and a comprehensive individual patient data systemic review and meta-analysis to critically appraise evidence on the utility of early escalation to advanced therapies with respect to short-, medium-, and long-term outcomes. In UC, the utility of the early escalation concept for the purposes of changing the natural history, including reducing colectomy and hospitalizations, is not supported by the available data. Data on targeting clinical, biochemical, endoscopic, and histological outcomes are needed to demonstrate that they are meaningful with regard to achieving reductions in hospitalization and surgery, improving quality of life, and minimizing disability. Analyses of different populations of UC patients, such as those with \u2018relapsing &amp; remitting\u2019 disease or with severe or complicated disease course, are urgently needed. The costs and risk\/benefit profile of some of the newer advanced therapies should be carefully considered. In this clinical landscape, it appears premature to advocate an indiscriminate \u2018one size fits all\u2019 approach to escalating to advanced therapies early during the course of UC.<\/jats:p>","DOI":"10.1093\/ecco-jcc\/jjad106","type":"journal-article","created":{"date-parts":[[2023,6,23]],"date-time":"2023-06-23T03:44:24Z","timestamp":1687491864000},"page":"2002-2011","source":"Crossref","is-referenced-by-count":19,"title":["Lack of Benefit for Early Escalation to Advanced Therapies in Ulcerative Colitis: Critical Appraisal of Current Evidence"],"prefix":"10.1093","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3312-5139","authenticated-orcid":false,"given":"Johan","family":"Burisch","sequence":"first","affiliation":[{"name":"Gastro Unit, Medical Division, Copenhagen University Hospital \u2013 Amager and Hvidovre , Hvidovre , Denmark"},{"name":"Copenhagen Center for Inflammatory Bowel Disease in Children, Adolescents and Adults, Copenhagen University Hospital \u2013 Amager and Hvidovre , Hvidovre , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ekaterina","family":"Safroneeva","sequence":"additional","affiliation":[{"name":"Tillotts Pharma AG , Rheinfelden , Switzerland"},{"name":"Institute of Social and Preventive Medicine, University of Bern , Bern , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raphael","family":"Laoun","sequence":"additional","affiliation":[{"name":"Tillotts Pharma AG , Rheinfelden , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4698-9948","authenticated-orcid":false,"given":"Christopher","family":"Ma","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Community Health Sciences, University of Calgary , Calgary, AB , 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