In this task, you are given a multiple-choice question about healthcare. Answer the question based on your information and classify your answers into '1', '2', '3', and '4'.
Q: Question: A 37-year-old woman with an extensive ulcerative colitis has a severe outbreak where treatment with prednisone is started at a dose of 1 mg / kg. After a week of treatment, the patient does not show improvement. What is the next therapeutic measure to perform?
Options: <1> Subtotal colectomy of urgency and in a second time proctectomy and ileoanal reservoir. <2> Associate an immunosuppressant such as azathioprine. <3> Associate mesalazine in doses of 4 grams per day oral and rectal triamcinolone 1 application every 12 hours <4> Endovenous cyclosporine 2 mg / Kg. <5> Treatment with etanercept (an anti-TNFa antibody) should be assessed.
A:
4