5a. In adult outpatients with moderate-severe ulcerative colitis, the AGA suggests combining TNFα antagonists, vedolizumab or ustekinumab with thiopurines or methotrexate, rather than biologic monotherapy. (Conditional recommendation, low quality evidence)

Comment: Patients, particularly those with less severe disease, who place higher value on lower risk of adverse events with biologic monotherapy, and lower value on the relative efficacy of combination therapy, may reasonably chose biologic monotherapy.

5b. In adult outpatients with moderate-severe ulcerative colitis, the AGA suggests combining TNFα antagonists, vedolizumab or ustekinumab with thiopurines or methotrexate, rather than thiopurine monotherapy. (Conditional recommendation, low quality evidence)