Ulcerative Colitis Clinical Trials in the UK (2026)
26 May 20269 min readTrialConnect Research Team
Ulcerative colitis (UC) affects around 160,000 people in the UK — more than Crohn's disease. It causes inflammation and ulceration of the rectum and colon, leading to bloody diarrhoea, urgency, and fatigue. While many patients achieve remission with existing treatments, a significant proportion experience relapse, steroid dependence, or acute severe flares requiring hospital admission. Clinical trials are expanding treatment options at every stage of the disease.
UC research in the UK benefits from the same infrastructure as Crohn's — the IBD BioResource, NIHR Clinical Research Network, and dedicated IBD units across the country. However, UC trials often differ in focus, particularly in the study of acute severe colitis (a medical emergency) and long-term colorectal cancer surveillance.
Currently there are over 100 actively recruiting UC trials in the UK. The treatment paradigm is shifting towards earlier use of advanced therapies, mucosal healing as a treatment target, and steroid-free remission as the primary goal.
Biologic Therapy Trials
Biologics have transformed UC management, and the pipeline continues to grow:
Anti-TNF agents — infliximab, adalimumab, and golimumab; ongoing trials optimise dosing, therapeutic drug monitoring, and biosimilar switching
Anti-integrin (vedolizumab) — gut-selective biologic with ongoing trials in combination therapy and as a first-line biologic
Anti-IL-12/23 (ustekinumab) — increasingly used in UC, with trials exploring earlier use and predictor biomarkers
Next-generation anti-IL-23 — mirikizumab, guselkumab, and risankizumab showing impressive efficacy in UC-specific trials
Novel targets — including TL1A (a target at the intersection of inflammation and fibrosis), Oncostatin M, and TNF-like cytokine pathways
JAK Inhibitors and Oral Therapies
Oral therapies are increasingly important in UC, offering convenience over injections and infusions:
Tofacitinib — the first JAK inhibitor approved for UC, with ongoing trials in combination with biologics
Upadacitinib — selective JAK1 inhibitor showing strong efficacy in UC, including in patients who have failed biologics
Etrasimod — S1P receptor modulator (oral) that traps lymphocytes in lymph nodes, reducing gut inflammation
Next-generation selective JAK inhibitors — targeting specific JAK subtypes to improve the safety profile
Acute Severe Colitis Studies
Acute severe ulcerative colitis (ASUC) is a medical emergency requiring hospital admission. UK trials in this area include:
Optimised infliximab dosing — accelerated infliximab induction regimens for patients with high inflammatory burden
Ciclosporin vs infliximab — the ongoing CONSTRUCT trial comparing these rescue therapies head-to-head
Early colectomy decision-making — tools and biomarkers to predict which patients need surgery vs medical rescue
Post-rescue maintenance — the best strategy to maintain remission after successful rescue therapy
Enteral nutrition — nutritional support strategies during acute flares
Colorectal Cancer Prevention
Patients with extensive UC have an increased risk of colorectal cancer, particularly after 8–10 years of disease. Prevention trials include:
Chemoprevention — testing whether medications (including 5-ASAs and statins) can reduce cancer risk
Surveillance optimisation — using advanced imaging (chromoendoscopy, AI-assisted analysis) to detect dysplasia earlier
Biomarker-guided surveillance — using molecular markers to personalise surveillance intervals
Microbiome and FMT Trials
The gut microbiome is increasingly recognised as a key factor in UC:
Faecal microbiota transplantation (FMT) — multiple UK trials testing FMT for induction and maintenance of remission in UC, using various delivery methods (colonoscopic, nasoduodenal, capsule)
Defined microbial consortia — engineered cocktails of beneficial bacteria, more controlled than donor FMT
Postbiotic therapies — using the metabolic products of healthy gut bacteria
Dietary interventions — Mediterranean diet, low-FODMAP, and specific exclusion diets for UC maintenance
Eligibility for UC Trials
UC trial eligibility typically requires:
Confirmed diagnosis of ulcerative colitis (endoscopy and histology)
Disease extent — proctitis, left-sided, or extensive/pancolitis (Montreal classification)
Active disease — measured by Mayo score, partial Mayo score, or endoscopic assessment
Treatment history — documentation of prior therapies and reasons for failure
For biologic trials: defined washout periods from previous biologics
💡 Know Your Disease Extent
Your most recent colonoscopy report will state your disease extent (proctitis, left-sided, or extensive). This is crucial for trial eligibility, as some trials only accept patients with specific extents of disease. If you are unsure, ask your gastroenterologist or IBD nurse.
UK Trial Centres
Major UK UC trial centres include:
London — Royal London Hospital, St Mark's Hospital, UCLH, St Thomas'
Oxford — John Radcliffe Hospital
Cambridge — Addenbrooke's Hospital
Newcastle — Royal Victoria Infirmary
Manchester — Salford Royal, Manchester University NHS Foundation Trust
Leeds — Leeds Teaching Hospitals
Edinburgh — Western General Hospital
Glasgow — Glasgow Royal Infirmary
Exeter — Royal Devon and Exeter Hospital
How to Find Your Match
Our Smart Matcher can help you find UC trials tailored to your disease extent, severity, treatment history, and current symptoms. It only takes a few minutes.
Find Ulcerative Colitis Trials For You
Our Smart Matcher uses your UC type, treatment history, and biomarkers to find the most relevant clinical trials.