Guidance
Recommendations for research
Recommendations for research
The guideline committee has made the following key recommendations for research. As part of the 2019 update, the guideline committee made an additional 3 recommendations for research on inducing remission in mild-to-moderate ulcerative colitis.
Key recommendations for research
1 The effectiveness of immunomodulators in inducing remission in proctitis
In a mild-to-moderate first presentation or inflammatory exacerbation of proctitis that is resistant to standard treatment, what is the effectiveness of topical immunomodulators, such as tacrolimus, in achieving clinical remission and what is the most effective formulation (suppository/ointment)?
For a short explanation of why the committee made the recommendation for research, see the rationale on proctitis.
Full details of the evidence and the committee's discussion are in evidence review: induction of remission in mild-to-moderate ulcerative colitis.
2 The effectiveness of immunomodulators in unresponsive ulcerative colitis
What is the effectiveness of oral tacrolimus and systemic (intramuscular/subcutaneous/oral) methotrexate in the induction of remission in mild-to-moderate ulcerative colitis unresponsive to aminosalicylates?
For a short explanation of why the committee made the recommendation for research, see the rationale on extensive ulcerative colitis.
Full details of the evidence and the committee's discussion are in evidence review: induction of remission in mild-to-moderate ulcerative colitis.
3 The relative effectiveness of corticosteroids for inducing remission in ulcerative colitis
What is the clinical and cost effectiveness of prednisolone, budesonide, and beclometasone in addition to aminosalicylates compared with each other and with aminosalicylate monotherapy for the induction of remission for people with mild-to-moderate ulcerative colitis?
For a short explanation of why the committee made the recommendation for research, see the rationale on all extents of disease.
Full details of the evidence and the committee's discussion are in evidence review: induction of remission in mild-to-moderate ulcerative colitis.
Other recommendations for research from the 2019 update
4 Induction of remission for people with moderate ulcerative colitis: prednisolone compared with aminosalicylates
What is the clinical and cost effectiveness of prednisolone compared with aminosalicylates for the induction of remission for people with moderate ulcerative colitis?
5 Induction of remission for people with moderate ulcerative colitis: prednisolone compared with beclometasone
What is the clinical and cost effectiveness of prednisolone plus an aminosalicylate compared with beclometasone plus an aminosalicylate for induction of remission for people with moderate ulcerative colitis?
6 Induction of remission for people with subacute ulcerative colitis that is refractory to systemic corticosteroids
What are the benefits, risks and cost effectiveness of methotrexate, ciclosporin, tacrolimus, adalimumab and infliximab compared with each other and with placebo for induction of remission for people with subacute ulcerative colitis that is refractory to systemic corticosteroids?
Other recommendations for research from the 2013 guideline
7 Methotrexate, ciclosporin, tacrolimus, adalimumab and infliximab
What are the benefits, risks and cost effectiveness of methotrexate, ciclosporin, tacrolimus, adalimumab and infliximab compared with each other and with placebo for induction of remission for people with subacute ulcerative colitis that is refractory to systemic corticosteroids?
8 Regular maintenance treatment compared with no regular treatment
What is the clinical and cost effectiveness of regular maintenance treatment compared with no regular treatment (but rapid standard treatment if a relapse occurs) in specific populations with mild to moderate ulcerative colitis?
9 Risk tool that predicts the likely need for surgery
To develop and validate a risk tool that predicts the likelihood of needing surgery for adults admitted to hospital with acute severe ulcerative colitis.
10 Routine monitoring of bone density in children and young people
In children and young people with ulcerative colitis receiving steroid treatment, what are the clinical benefits of routine monitoring of bone density, what tests should be done and how frequently?
11 Registry for drug treatments in pregnant women
A registry to collect data to answer 'What are the potential harms or benefits of drug treatments in pregnant women with ulcerative colitis?'
12 Information needs for surgery
What are the information needs of people with ulcerative colitis when they are considering surgery?
13 Sulphasalazine compared to high-dose branded mesalazine
What is the clinical and cost effectiveness of sulphasalazine compared to high-dose branded mesalazine for induction of remission for people with mild moderate ulcerative colitis?
14 Validity, reliability and accuracy of available adult risk tools as a predictor for the need for surgery
What is the validity, reliability and accuracy of available adult risk tools as a predictor for the need for surgery in people admitted into hospital with acute severe ulcerative colitis?
15 Paediatric Ulcerative Colitis Activity Index (PUCAI) as a predictor for surgery for children and young people
What is the validity, reliability and accuracy of the Paediatric Ulcerative Colitis Activity Index (PUCAI) as a predictor for surgery for children and young people admitted to hospital with acute severe colitis?
16 Second-line treatment strategies for induction of remission after people have failed to respond to ASA mono or combination therapies
In people with mild to moderate ulcerative colitis, what are the best second-line treatment strategies for induction of remission after people have failed to respond to ASA mono or combination therapies?
17 Second-line treatment strategies for induction of remission after people have failed to respond to oral prednisolone
In people with subacute ulcerative colitis, what are the best second-line treatment strategies for induction of remission after people have failed to respond to oral prednisolone?
18 Best strategies for the induction of remission after people have failed to respond to tacrolimus
In people with mild to moderate ulcerative colitis, what are the best strategies for the induction of remission after people have failed to respond to tacrolimus?
19 National registry to identify the incidence of growth failure and/or pubertal delay
Establish a national registry to identify the incidence of growth failure and/or pubertal delay in ulcerative colitis and the relationship with treatment (to record treatment [steroids, ASA, immunomodulators] and growth [z scores]).