Scientific research and the development of new treatments for ulcerative colitis (UC) are ongoing. In the last few years, new UC medications and treatments have emerged.

UC is a chronic (long-term) inflammatory bowel disease (IBD). It happens when an immune system response causes inflammation in the inner lining of the large intestine. It’s not clear what triggers this response.

Medication to lower inflammation is the main treatment. There’s a growing list of medications approved for the treatment of UC. And biosimilars are expanding options even more.

Research into the causes and contributing factors of UC is ongoing. Scientists are looking into such topics as the microbiome, genetics, and environmental factors.

Finding the cause of UC may be the key to more effective treatments. It could also lead to strategies to help prevent UC in the first place.

In this article, we’ll discuss new treatments and studies on UC and where the research is heading.

A 2025 study evaluated the role of montelukast, a medication commonly used for asthma and allergies, in helping to maintain remission (when symptoms lessen or go away) in people with UC who already have clinical remission. The medication may provide a low-cost addition to remission maintenance in people who are tapering off steroids.

Another study from 2024 looked at people with UC after having surgery to remove their colon. Those who developed pouchitis (inflammation in the pouch created during surgery to replace the rectum) had lower levels of certain healthy gut bacteria and digestive chemicals that keep the gut healthy. Researchers believe future studies might help develop supplements or treatments to give people the bacteria needed to help prevent pouchitis.

A 2020 study evaluated the role of gut microbes in intestinal inflammation.

When medications don’t effectively manage UC symptoms, surgery may be the next step. This may involve removing the colon and creating an ileal-anal pouch to function in place of the rectum.

In the 2020 study, about half of the people who had this procedure due to UC continue to have inflammation of the pouch (pouchitis). But that’s rarely the case for people who have the surgery for other reasons.

The researchers found that those who developed pouchitis had low levels of secondary bile acids in their digestive tracts. They also had low levels of Ruminococcaceae bacteria. If confirmed, this could lead to the development of supplements to provide the missing gut microbes or restore the bacteria that produce them.

A 2021 study highlighted bacterial changes in the gut prior to developing UC. With further research, doctors may be able to identify people at risk of UC. This could pave the way for precision drugs designed to help prevent UC.

Other avenues of research into the causes of UC include:

  • environmental factors
  • lifestyle factors like smoking, diet, and exercise
  • genetics

Ongoing research in treatment options includes:

There are currently dozens of medications to treat UC. Your doctor may prescribe one or more of the following:

  • Aminosalicylates (5-ASA): These medications are taken orally or rectally to reduce inflammation in the lining of the gastrointestinal tract. They’re effective at treating mild to moderate UC flares.
  • Corticosteroids: For moderate to severe UC, your doctor may prescribe corticosteroids. They suppress the immune system response. Corticosteroids should not be used long term due to the risk of side effects.
  • Immunosuppressants: This class of medication suppresses the immune system to help lower inflammation. Your doctor may prescribe immunosuppressants if aminosalicylates and corticosteroids have not been effective.
  • Biologics: Biologic medications are used to treat people with moderate to severe UC. They target specific proteins in the body that cause inflammation.
  • Biosimilars: A biosimilar drug is nearly identical to an existing Food and Drug Administration (FDA)-approved biologic medication.
  • Janus kinase (JAK) inhibitors: JAK inhibitors block an enzyme involved in triggering inflammation.

Recent approvals

Several UC medications have been approved in the past few years.

Medications approved in 2024 include:

  • Risankizumab (Skyrizi): This medication is also used to treat adults with moderate to severe plaque psoriasis. The FDA approved the injected drug to treat UC as a new option for those with IBD to enter into remission.

Medications approved in 2023 include:

  • Mirikizumab (Omvoh): This medication is for adults with moderate to severe UC. It’s the first and only interleukin-23p19 (IL-23p19) antagonist approved to treat moderate to severe UC.
  • Etrasimod (Velsipity): This selective sphingosine-1-phosphate (S1P) receptor modulator is approved for adults with moderate to severe UC. It’s a pill that’s taken once daily.
  • Ustekinumab (Stelara): This biosimilar drug is approved to treat adults with moderate to severe Crohn’s disease and moderate to severe active UC.
  • Ustekinumab-auub (Wezlana): This is another biosimilar drug approved to treat adults with moderate to severe plaque psoriasis, active psoriatic arthritis, moderate to severe UC, and Crohn’s disease.

Medications approved in 2021 include:

  • Ozanimod (Zeposia): This medication is for adults with moderate to severe UC. It’s the first oral sphingosine 1-phosphate (S1P) receptor modulator approved for UC. Results of phase 2 and phase 3 clinical trials suggest it’s an effective first-line and maintenance therapy. It was also generally well tolerated.
  • Adalimumab (Humira): Adalimumab is a type of biologic called a tumor necrosis factor (TNF) blocker. It was approved for UC in 2012. In 2021, it became the first subcutaneous biologic treatment approved for people ages 5 and up with moderate to severe UC. Phase 3 clinical trials showed clinically meaningful rates of remission and response in children.
  • Adalimumab-adbm (Cyltezo): This is a biosimilar approved for adults with moderate to severe UC.

Medications approved in 2019 and 2020 include:

  • Adalimumab-fkjp (Hulio): This is a biosimilar approved for adults with moderate to severe UC who’ve had an inadequate response to other therapy.
  • Infliximab-axxq (Avsola): A biosimilar, infliximab-axxq is a treatment option approved for adults with moderate to severe UC who’ve had an inadequate response to other therapy.

Clinical trials study the safety and effectiveness of new treatments. Enrolling in a trial can give you access to treatments that aren’t yet available anywhere else. Your doctor can help you locate clinical trials and assess your eligibility.

These are just a few of the clinical trials for UC that are currently enrolling:

  • A Study of Eltrekibart and Mirikizumab in Adult Patients With Moderately to Severely Active Ulcerative Colitis: The goal of this trial is to determine how safe and effective the drugs eltrekibart and mirikizumab are in adults with moderate to severe UC.
  • Butyrate Therapy in Hispanic Children With Ulcerative Colitis: This trial will evaluate the use of a metabolite made by the gut to see if it can help improve mild to moderate UC in children.
  • Adherence of a 1.600 mg Single Tablet 5-ASA Treatment of Ulcerative Colitis (EASI): The EASI trial will investigate whether a simpler treatment regimen for 5-ASA improves adherence while preserving remission rates versus conventional therapy.
  • Hyperbaric Oxygen Therapy for Ulcerative Colitis (HBOT-UC) (HBOT-UC): This larger trial will look at the treatment benefits of hyperbaric oxygen therapy (HBOT) for reducing moderate to severe flares of UC.
  • Treatment of Ulcerative Colitis With Novel Therapeutics: This trial will investigate the effectiveness of the drug BRS201 as a treatment for mild UC.
  • Adipose Mesenchymal Stem Cells (AMSC) for Treatment of Ulcerative Colitis (AMSC_UC): This trial will evaluate the safety and efficacy of intracolonic injections of AMSCs in people with moderate UC. Recent research shows mesenchymal stem cells may have anti-inflammatory properties.

You can learn more about these and other clinical trials at clinicaltrials.gov.

In the search for a cause of UC, studies have identified at least 260 genetic variants that may affect the risk of IBD. As it has for other diseases, knowing genetic risk factors may lead to the further development of prevention strategies and precision medication for UC.

Healthcare technology may also advance treatment for UC. Digital apps and biosensors are hot topics in research, as is the use of AI-powered tools.

Researchers from the University of Texas at Dallas designed the first wearable device that can monitor sweat for inflammation biomarkers. The researchers suggest that tracking inflammation may help identify IBD flare-ups. It could also let doctors know if the current therapy is working.

According to a 2024 review of studies, there’s some evidence that the Mediterranean diet may help improve quality of life and lower disease activity in people with IBD.

Per the Crohn’s & Colitis Foundation, IBD research gaps that should be prioritized include:

  • noninvasive detection and monitoring of active inflammation and assessment of treatment response
  • mucosal targeted drug delivery systems
  • prevention of postoperative septic complications and treatment of fistulizing complications

The outlook for people with UC is better today than ever before. This is largely due to newer medications that help manage inflammation in the colon. A wider choice of medications means that if your treatment isn’t working, you have other options.

As researchers learn more about the causes of UC, we can expect new advances in treatment. Identifying risk factors may also help doctors prevent UC from developing.

Research is advancing at a rapid pace. So, there’s plenty of reason for hope.

If you have UC, talk with your doctor about the latest findings and how they might affect your treatment.