Acute severe ulcerative colitis is a serious condition that requires early
hospitalization, with intensive monitoring and treatment. Despite the recent
progress in the medical approach of Inflammatory Bowel Diseases acute severe
ulcerative colitis remains a clinical challenge, with a mortality rate of nearly
1%. As of today, I.V. corticosteroids remain the 1(st)-line therapy for this
complication. For non-responders (up to one-third of patients) possible options
are surgery - whose timing is a critical point in the overall management of the
disease - or rescue therapy with 2(nd)- line agents such as Cyclosporine and
Infliximab. Here we will review the published studies dealing with the use of
these medications in acute severe ulcerative colitis.
