PURPOSE OF REVIEW: Ulcerative colitis is a chronic inflammatory disease of the 
colon of unknown cause that is characterized by alternating intervals of active 
and inactive disease in 80-90% of patients. The primary goal of treatment is to 
induce and maintain remission using therapy tailored to the individual patient. 
The purpose of this review was to describe the management of ulcerative colitis 
with emphasis on the use of anti-tumor necrosis factor (TNF) agents.
RECENT FINDINGS: Recent research has shown that new anti-TNF agents, adalimumab 
(ADA) and golimumab, are effective in induction of remission and maintenance of 
remission in patients with extensive ulcerative colitis. In a recent study, 
infliximab was found to have comparable efficacy to cyclosporine in treatment of 
acute severe refractory to corticosteroids ulcerative colitis.
SUMMARY: Anti-TNF therapy should be initiated in patients with acute severe 
refractory to corticosteroids ulcerative colitis and in patients with 
moderate-to-severe ulcerative colitis who are not responsive to conventional 
treatment with aminosalicylates, corticosteroids and immune modulators. 
Alternatives to infliximab are ADA and golimumab. Future research is needed to 
further assess the long-term efficacy and safety of ADA and golimumab in 
ulcerative colitis.