Clinical guidelines are essential tools that help inform effective patient care. They are updated as treatment options improve and more data become available, enabling practitioners to stay aligned with the latest scientific advancements. Ulcerative colitis (UC) is a prime example of a disease with evolving treatment strategies.
UC is a common disease and significantly affects patients' quality of life; therefore, knowing the latest therapeutic developments is important. The American Gastroenterological Association (AGA) recently released a living guideline on UC, providing new insights and addressing changing treatment options.
Understanding the Changes
The AGA guideline introduced several updates, primarily focusing on new treatments and effective positioning of treatments. Areas of focus include:
- Updated treatment algorithms: Revised strategies for incorporating biologics and small molecules into treatment plans.
- Stratification of disease severity: More detailed guidance on categorizing UC based on severity.
- Remission maintenance and step-up/step-down therapies: Updated approaches to remission in patients with UC, emphasizing flexible step-up or step-down strategies based on disease progression.
New medications and studies prompted the AGA to adopt this living guideline, providing clinicians with real-time recommendations so that treatment plans align with the latest research. What practitioners were taught in fellowship or learned three years ago may not be applicable today.
Impact on Gastroenterology Professionals
When a new drug is released, recommendations can shift, sometimes based on subtle differences in clinical scenarios. The updates directly impact how gastroenterologists diagnose and treat UC and highlight the importance of staying informed about the current standards of care. For example, rapid approval of new medicines presents challenges to clinical workflows because it is necessary to determine their applicability and navigate hurdles like establishing billing codes and the cumbersome insurance approval processes. Despite the potential benefits of new drugs, they are not always immediately covered by insurance. The complexities of insurance approvals and reimbursement hinder the adoption of newer therapies, limiting patient access. This variability creates frustration as clinicians strive to stay current.
Looking Ahead: Future Trends
Looking forward, there are exciting possibilities for inflammatory bowel disease treatment as well as other areas of GI, including reflux disease and liver disease. Emerging therapies, particularly in areas such as fatty liver disease and GERD, are expected to transform the treatment landscape. Ongoing studies yield even more treatment options as precision medicine is poised to play a bigger role and drive future guideline revisions.
Final Advice to Stay Up to Date
Read as much as possible. Set aside time to do it! Build it into your routine. This commitment to continuous learning helps physicians remain well-informed and provide the best possible care to their patients.
Adam Gluskin, MD, is a gastroenterologist with Illinois Gastroenterology Group–Arlington Heights (Northeast Gastroenterologists), GI Alliance of Illinois.