Case 3: Pregnancy in a Patient With Ulcerative Colitis

Jointly provided by

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Support for this activity has been provided through educational grants from Janssen Biotech, Inc, administered by Janssen Scientific Affairs and Takeda Pharmaceuticals International, U.S. Region.

Release date: 12/30/2014

Expiration date: 12/30/2015

Estimated time to complete: 0.5 hours


Patients with ulcerative colitis (UC) often receive inadequate or inappropriate treatment. Management of UC is based on the assessment of disease activity, which is represented by both clinical symptoms and mucosal inflammation. This Virtual Practice has been developed to simulate the day-to-day challenges encountered by clinicians who provide care to patients with UC. The activity outlines strategies that optimize treatment outcomes through the precise balance of safety considerations and efficacy. It also reviews new and emerging therapies that can improve upon the efficacy or safety of currently available options and how they can be applied in practice.

Managing UC during pregnancy is an important but often overlooked topic. This case follows Laura, a patient with UC who is interested in starting a family, and addresses many of the misconceptions and challenges involved in managing UC during pregnancy.


David T. Rubin, MD—Program Chair
Joseph B. Kirsner Professor of Medicine
Chief, Section of Gastroenterology, Hepatology and Nutrition
Co-Director, Digestive Diseases Center
University of Chicago Medicine
Chicago, Illinois

Christina Y. Ha, MD
Clinical Assistant Professor
Division of Digestive Diseases
David Geffen School of Medicine
University of California, Los Angeles
Los Angeles, California

Kian Keyashian, MD
Assistant Professor of Medicine
Division of Gastroenterology
Oregon Health & Science University
Portland, Oregon

Target Audience

This activity has been designed to meet the educational needs of gastroenterologists and other health care professionals who are involved in the management of patients with UC.

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Design effective strategies for managing UC that take into consideration the indications, risks, and benefits of long-term nonbiologic and biologic therapies

Accreditation and Credit Designation

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the University of Chicago Pritzker School of Medicine and RedMedEd. The University of Chicago Pritzker School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.

The University of Chicago Pritzker School of Medicine designates this enduring material for a maximum of 0.5 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 


The University of Chicago Pritzker School of Medicine and RedMedEd adhere to the ACCME Essential Areas, Standards for Commercial Support, and Policies regarding industry support of continuing medical education. In accordance with the ACCME Standards for Commercial Support, all CME providers are required to disclose to the activity audience the relevant financial relationships of everyone in a position to control content of an educational activity. A relevant financial relationship is a relationship in any amount occurring in the last 12 months with a commercial interest whose products or services are discussed in the CME activity content over which the individual has control. Relationship information appears below:

Christina Y. Ha, MD, has disclosed the following relevant financial relationships:
Ad Board/Speaker/Consultant: AbbVie
Speaker: Takeda

Kian Keyashian, MD, has disclosed no relevant financial relationships.

David T. Rubin, MD, has disclosed the following relevant financial relationships:
Consultant: AbbVie, Emmi, Ironwood, Janssen, Prometheus Pharmaceuticals, Santarus/Salix, Takeda, Telsar Pharmaceuticals, UCB Pharma, Vertex Pharmaceuticals
Grant support: AbbVie, Elan Pharmaceuticals, Prometheus Pharmaceuticals, Shire, Warner Chilcott
Cofounder: Cornerstones Health, Inc.

University of Chicago Pritzker School of Medicine
The employees of the University of Chicago Pritzker School of Medicine have disclosed no relevant financial relationships.

Thomas Finnegan, PhD, Medical Director, has disclosed no relevant financial relationships.
Lauren Showers, Project Manager, has disclosed no relevant financial relationships.
Jonathan S. Simmons, ELS, Senior Managing Editor, has disclosed no relevant financial relationships.
Karen Smith, Creative Director, has disclosed no relevant financial relationships.

Unapproved Product Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the US Food and Drug Administration. RedMedEd, the University of Chicago Pritzker School of Medicine, Janssen, and Takeda do not recommend the use of any agent outside the labeled indications.

Generic Name Trade Name Approved Use (if any) Unapproved/
Investigational Use
Allopurinol Aloprim, Zyloprim Indicated for the management of patients with signs and symptoms of primary or secondary gout; management of patients with leukemia, lymphoma, and malignancies who are receiving cancer therapy that causes elevations of serum and urinary uric acid levels; management of patients with recurrent calcium oxalate calculi whose daily uric acid excretion exceeds 800 mg/day (male patients) and 750 mg/day (female patients) Adjunctive therapy in patients with UC
Azathioprine Azasan Indicated as an adjunct for the prevention of rejection in renal homotransplantations; treatment of active rheumatoid arthritis to reduce signs and symptoms Maintenance therapy for UC
Mercaptopurine Purinethol Indicated for maintenance therapy of acute lymphatic (lymphocytic, lymphoblastic) leukemia as part of a combination regimen Maintenance therapy for UC


The information presented in this activity is for continuing medical education purposes only and is not meant to substitute for the independent medical judgment of a physician regarding diagnosis and treatment of a specific patient’s medical condition.

The opinions expressed in this educational activity are those of the faculty and do not necessarily represent the views of RedMedEd, the University of Chicago Pritzker School of Medicine, Janssen, or Takeda. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Method of Participation

There are no fees to participate in the activity. Participants must review all activity information, including the learning objectives, disclosure statements, and content. To receive CME credit for participation, participants must complete the posttest (achieving a grade of 80% or greater) and program evaluation. Certificates can be printed immediately.

Hardware/Software Requirements

  • Apple iPad or iPad mini (iOS 7 or higher) with an Internet connection
  • A computer with an Internet connection
    • Internet browser: Google Chrome, Internet Explorer 9 or higher, Firefox 26 or higher, or Safari 5 or higher
    • Additional software: Adobe Flash Player and/or an HTML 5-capable browser is required for video or audio playback; Adobe Acrobat Reader may occasionally be required


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