Condition

Ulcerative Colitis

Inflammatory bowel disease causing ulcers in the colon

1.9M
People Affected
15
Active Trials
38K
New Cases/Year
5,000
Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

1
Prednisone
85% Effectiveness• 90% Confidence• 50% Safety• 13 trials• 40K participants
HIGH EvidenceExcellent ValueDose: 40-60 mg/day, then tapered
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
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50
DangerousModerateSafe

Time to Effect

Days to 1 week

Duration

Short courses (8-12 weeks taper)

Response Rate

80%

Remission Rate

50%

Number Needed to Treat (NNT)

2

Number Needed to Harm (NNH)

8

Common Side Effects:

Insomnia/Mood changes: 40%
Increased appetite/Weight gain: 40%
Fluid retention: 30%
Hyperglycemia: 15%
GI upset: 8%

Annual Cost of Care

Drug Cost

$125

Monitoring

$200

Side Effects

$125

Total Annual

$450

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.12

Cost per Remission

$900

Cost per Responder

$562.5

Treatment Outcomes
Primary Outcomes
Mayo ScoreMayo Score: 9/12 (severe disease activity)
-66.67% (-6 points)
Rectal Bleeding ScoreRectal Bleeding Score: 2/3 (frequent/moderate blood)
-75% (-1.5 points)
Stool Frequency ScoreStool Frequency Score: 2/3 (5-8 stools/day)
-75% (-1.5 points)
Secondary Benefits
C-Reactive Protein (CRP)15 mg/L (elevated)
-80% (-12 mg/L)
Faecal Calprotectin800 µg/g (very high)
-75% (-600 µg/g)
Inflammatory Bowel Disease Questionnaire (IBDQ)IBDQ Score: 100/224 (poor quality of life)
+60% (+60 points)
Common Side Effects
Insomnia/Mood changes
+40%
Increased appetite/Weight gain
+40%
Fluid retention
+30%

Clinical Trial Phases:

Phase 4
2
Infliximab
80% Effectiveness• 95% Confidence• 60% Safety• 118 trials• 20K participants
HIGH EvidenceGood ValueDose: 5 mg/kg IV at weeks 0, 2, 6, then every 8 weeks
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
60
DangerousModerateSafe

Time to Effect

2-6 weeks

Duration

Long-term

Response Rate

70%

Remission Rate

40%

Number Needed to Treat (NNT)

4

Number Needed to Harm (NNH)

15

Common Side Effects:

Infusion reactions: 12%
Infections (URI, UTI): 20%
Headache: 12%
Antibody formation: 10%
Serious infections: 2%

Annual Cost of Care

Drug Cost

$22,500

Monitoring

$2,000

Side Effects

$1,250

Total Annual

$25,750

Cost-Effectiveness

GOOD

QALYs Gained

1

ICER

$40,000/QALY

Cost per Remission

$64,375

Cost per Responder

$36,785.71

Treatment Outcomes
Primary Outcomes
Mayo Score9/12 points (moderate-severe UC)
-61% (-5.5 points)
Endoscopic Mayo Score2.5/3 points (moderate-severe inflammation)
-68% (-1.7 points)
C-Reactive Protein25 mg/L (elevated)
-70% (-17.5 mg/L)
Fecal Calprotectin700 µg/g (highly elevated)
-75% (-525 µg/g)
Secondary Benefits
IBDQ Score140/224 points (impaired QoL)
+18% (+25 points)
Serum Albumin3.2 g/dL (mildly low)
+19% (+0.6 g/dL)
Prednisone Equivalent Daily Dose15 mg/day
-80% (-12 mg/day)
Common Side Effects
Infusion reactions
+12%
Infections (URI, UTI)
+20%
Headache
+12%

Clinical Trial Phases:

Phase 4
3
Mesalamine
75% Effectiveness• 90% Confidence• 75% Safety• 144 trials• 50K participants
HIGH EvidenceGood ValueDose: Oral: 1.2-4.8 g/day; Rectal: 1g daily
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
75
DangerousModerateSafe

Time to Effect

2-4 weeks

Duration

Lifetime

Response Rate

60%

Remission Rate

40%

Number Needed to Treat (NNT)

5

Number Needed to Harm (NNH)

500

Common Side Effects:

Headache: 18%
Nausea: 12%
Diarrhea: 7%
Abdominal pain: 7%
Rash: 2%

Annual Cost of Care

Drug Cost

$1,800

Monitoring

$350

Side Effects

$125

Total Annual

$2,275

Cost-Effectiveness

GOOD

QALYs Gained

0.2

Cost per Remission

$5,687.5

Cost per Responder

$3,791.67

Treatment Outcomes
Primary Outcomes
Mayo Clinic Score8/12
-44% (-3.5 points)
Endoscopic Subscore (Mayo)2/3
-50% (-1 point)
Rectal Bleeding Subscore (Mayo)2/3
-75% (-1.5 points)
Fecal Calprotectin700 µg/g
-40% (-280 µg/g)
Secondary Benefits
IBDQ Score140/224
+29% (+40 points)
C-reactive Protein (CRP)15 mg/L
-35% (-5.3 mg/L)
Abdominal Pain Score (0-10 VAS)6/10
-42% (-2.5 points)
Common Side Effects
Headache
+18%
Nausea
+12%
Diarrhea
+7%

Clinical Trial Phases:

Phase 4
4
Vedolizumab
75% Effectiveness• 90% Confidence• 65% Safety• 110 trials• 5K participants
HIGH EvidenceModerate ValueDose: 300 mg IV at weeks 0, 2, 6, then every 8 weeks
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
65
DangerousModerateSafe

Time to Effect

6-10 weeks

Duration

Long-term

Response Rate

60%

Remission Rate

27.5%

Number Needed to Treat (NNT)

6

Number Needed to Harm (NNH)

75

Common Side Effects:

Nasopharyngitis: 12%
Headache: 12%
Arthralgia: 8%
Nausea: 7%
Serious infections: 2.5%

Annual Cost of Care

Drug Cost

$40,000

Monitoring

$2,000

Side Effects

$1,000

Total Annual

$43,000

Cost-Effectiveness

MODERATE

QALYs Gained

0.8

ICER

$264,000/QALY

Cost per Remission

$156,363.64

Cost per Responder

$71,666.67

Treatment Outcomes
Primary Outcomes
Total Mayo Score9 (scale 0-12)
-44.4% (-4.0 points)
Rectal Bleeding Subscore2.5 (scale 0-3)
-72% (-1.8 points)
Stool Frequency Subscore2.5 (scale 0-3)
-60% (-1.5 points)
Endoscopic Subscore (Mayo)2.5 (scale 0-3)
-60% (-1.5 points)
Secondary Benefits
C-reactive protein (CRP)15 mg/L
-66.7% (-10 mg/L)
Fecal Calprotectin800 5g/g
-62.5% (-500 5g/g)
IBD Questionnaire (IBDQ) Score140 (scale 32-224)
+17.9% (+25 points)
Common Side Effects
Nasopharyngitis
+12%
Headache
+12%
Arthralgia
+8%

Clinical Trial Phases:

Phase 4
5
Ustekinumab
75% Effectiveness• 85% Confidence• 65% Safety• 32 trials• 2K participants
HIGH EvidenceModerate ValueDose: IV induction (6 mg/kg), then 90 mg SC every 8 weeks
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
65
DangerousModerateSafe

Time to Effect

8-12 weeks

Duration

Long-term

Response Rate

60%

Remission Rate

27.5%

Number Needed to Treat (NNT)

6

Number Needed to Harm (NNH)

75

Common Side Effects:

Nasopharyngitis: 12%
Headache: 12%
Injection site reactions: 8%
Abdominal pain: 7%
Serious infections: 2.5%

Annual Cost of Care

Drug Cost

$45,000

Monitoring

$2,000

Side Effects

$1,000

Total Annual

$48,000

Cost-Effectiveness

MODERATE

QALYs Gained

0.8

ICER

$250,000/QALY

Cost per Remission

$174,545.45

Cost per Responder

$80,000

Treatment Outcomes
Primary Outcomes
Mayo Score (Total)7 points (range 0-12)
-45% (-3.2 points)
Fecal Calprotectin (FC)800 µg/g
-60% (-480 µg/g)
Rectal Bleeding Subscore (Mayo)2.5 points (range 0-3)
-55% (-1.4 points)
Stool Frequency Subscore (Mayo)2.5 points (range 0-3)
-50% (-1.3 points)
Secondary Benefits
Inflammatory Bowel Disease Questionnaire (IBDQ) Total Score130 points (range 32-224)
+18% (+23 points)
C-reactive protein (CRP)15 mg/L
-50% (-7.5 mg/L)
Endoscopic Improvement (Mayo Endoscopic Subscore)2.5 points (range 0-3)
-55% (-1.4 points)
Common Side Effects
Nasopharyngitis
+12%
Headache
+12%
Injection site reactions
+8%

Clinical Trial Phases:

Phase 4
6
Tofacitinib
75% Effectiveness• 85% Confidence• 55% Safety• 37 trials• 3K participants
HIGH EvidenceModerate ValueDose: 10 mg twice daily for induction, then 5 mg twice daily for maintenance
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
55
DangerousModerateSafe

Time to Effect

4-8 weeks

Duration

Long-term

Response Rate

60%

Remission Rate

20%

Number Needed to Treat (NNT)

6

Number Needed to Harm (NNH)

35

Common Side Effects:

Nasopharyngitis: 18%
Headache: 12%
Upper respiratory tract infection: 12%
Herpes zoster: 3.5%
Serious infections: 3.5%

Annual Cost of Care

Drug Cost

$42,000

Monitoring

$2,500

Side Effects

$1,500

Total Annual

$46,000

Cost-Effectiveness

MODERATE

QALYs Gained

0.6

ICER

$200,000/QALY

Cost per Remission

$230,000

Cost per Responder

$76,666.67

Treatment Outcomes
Primary Outcomes
Mayo Score9/12 (moderate to severe UC)
-44% (-4 points)
Mayo Endoscopic Subscore2/3 (moderate to severe inflammation)
-50% (-1 point)
Rectal Bleeding Subscore2/3 (moderate bleeding)
-60% (-1.2 points)
C-Reactive Protein (CRP)15 mg/L (elevated)
-65% (-9.75 mg/L)
Secondary Benefits
Inflammatory Bowel Disease Questionnaire (IBDQ) Score120/224 (impaired quality of life)
+25% (+30 points)
Fecal Calprotectin800 µg/g (elevated)
-50% (-400 µg/g)
Stool Frequency Subscore2.5/3 (frequent stools)
-40% (-1.0 points)
Common Side Effects
Nasopharyngitis
+18%
Headache
+12%
Upper respiratory tract infection
+12%

Clinical Trial Phases:

Phase 4
7
Azathioprine
60% Effectiveness• 85% Confidence• 30% Safety• 29 trials• 15K participants
MODERATE EvidenceExcellent ValueDose: 2-2.5 mg/kg/day
Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
30
DangerousModerateSafe

Time to Effect

3-6 months

Duration

Long-term

Response Rate

50%

Remission Rate

30%

Number Needed to Treat (NNT)

5

Number Needed to Harm (NNH)

15

Common Side Effects:

Nausea/Vomiting: 12%
Fatigue: 8%
Pancreatitis: 5%
Leukopenia/Myelosuppression: 3%
Hepatotoxicity: 2%

Annual Cost of Care

Drug Cost

$200

Monitoring

$1,000

Side Effects

$300

Total Annual

$1,500

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.4

Cost per Remission

$5,000

Cost per Responder

$3,000

Treatment Outcomes
Primary Outcomes
Clinical Disease Activity (Mayo Score)Mayo Score: 8/12 (moderate-severe UC)
-62.5% (-5 points)
Endoscopic Activity (Mayo Endoscopic Subscore)Mayo Endoscopic Subscore: 2/3 (moderate inflammation)
-50% (-1 point)
Fecal Calprotectin800 µg/g
-75% (-600 µg/g)
C-Reactive Protein (CRP)15 mg/L
-60% (-9 mg/L)
Secondary Benefits
Quality of Life (IBD-QoL score)120/224 (impaired QoL)
+25% (+30 points)
Rectal Bleeding (Mayo Subscore)2/3 (frequent bleeding)
-50% (-1 point)
Hemoglobin11.0 g/dL (mild anemia)
+10% (+1.1 g/dL)
Common Side Effects
Nausea/Vomiting
+12%
Fatigue
+8%
Pancreatitis
+5%

Clinical Trial Phases:

Phase 4