Abstract：
Ulcerative colitis (US) is a chronic disease of unknown etiology. It is incurable and its clinical course is intermittent, characterized by periods of remission and relapse. The prevalence and incidence of the disease has been increasing worldwide. The update presented herein includes the participation of healthcare professionals, decision-makers, and a representative of the patients, all of whom declared their conflicts of interest. Answerable clinical questions were formulated, and the outcomes were graded. The information search was conducted on the Medline/PubMed, Embase, Epistemonikos, and LILACS databases, and covered grey literature sources, as well. The search was updated on November 30, 2020, with no restrictions regarding date or language. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) classification system was implemented to establish the strength of the recommendation and quality of evidence. A formal consensus was developed, based on the RAND/UCLA methodology and the document was peer reviewed. The short version of the Clinical Practice Guidelines for the Treatment of Ulcerative Colitis in the Adult Population is presented herein, together with the supporting evidence and respective recommendations. In mild-to-moderate UC, budesonide MMX is an option when treatment with 5-ASA fails, and before using systemic steroids. In moderate-to-severe UC, infliximab, adalimumab, vedolizumab, ustekinumab, and tofacitinib can be used as first-line therapy. If there is anti-TNF therapy failure, ustekinumab and tofacitinib provide the best results. In patients with antibiotic-refractory pouchitis, anti-TNFs are the treatment of choice.
摘要：
溃疡性结肠炎(US)是一种病因不明的慢性疾病。它是无法治愈的，它的临床过程是间歇性的，以缓解和复发为特征。该疾病的患病率和发病率在世界范围内一直在增加。本文提供的更新包括医疗保健专业人员的参与，决策者,和患者的代表，所有这些人都宣布了他们的利益冲突。制定了可回答的临床问题，并对结果进行分级。信息搜索是在Medline/PubMed上进行的，Embase,认识论，和LILACS数据库，并涵盖了灰色文献来源，也是。该搜索于2020年11月30日更新，没有日期或语言限制。建议评估的分级，实施了开发和评估（GRADE）分类系统，以建立推荐强度和证据质量。达成了正式共识，基于兰德/加州大学洛杉矶分校的方法，该文件经过同行评审。本文介绍了成人人群溃疡性结肠炎治疗临床实践指南的简短版本，以及支持证据和各自的建议。在轻度至中度UC中，当5-ASA治疗失败时，布地奈德MMX是一种选择，在使用全身性类固醇之前。在中度至重度UC中，英夫利昔单抗,阿达木单抗,维多珠单抗,ustekinumab,托法替尼可以作为一线治疗。如果抗TNF治疗失败，ustekinumab和tofacitinib提供了最好的结果。在抗生素难治性囊炎患者中，抗TNF是首选的治疗方法。
