Adalimumab, Tacrolimus Effective for Treating Refractory Ulcerative Colitis

Adverse effects were generally mild to moderate and managed conservatively, with no significant difference in events between the purine analogue and no purine analogue groups.

Dr. Buning recommends tacrolimus for “induction of remission as first- or second-line (after anti-TNF failure) in severe steroid-refractory ulcerative colitis without previous thiopurine failure, with early combination and de-escalation to thiopurine monotherapy after about 3–6 months.”

Lacking a head-to-head trial, it remains unclear which treatment—adalimumab or tacrolimus (plus a purine analogue)—would provide better outcomes for these patients.