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http://hdl.handle.net/1942/34527
Title: | Ulcerative colitis treatment : an insight into daily clinical practice | Authors: | Bossuyt, P. Baert, F. COENEGRACHTS, Jean-Louis De Vos, M. Dewit, O. Ferrante, M. Fontaine, F. Mana, F. Vandervoort, J. Moreels, T. |
Corporate Authors: | Belgian Inflammatory Bowel Disease Research and Development Group (BIRD) | Issue Date: | 2019 | Publisher: | Source: | ACTA GASTRO-ENTEROLOGICA BELGICA, 82 (3) , p. 365 -372 | Abstract: | Background : The natural history of ulcerative colitis (UC) is unpredictable. Factors associated with the need for different types of step-up therapy in UC patients failing on 5-aminosalicylic acid (5-ASA) or corticosteroids are understudied. Aims : Describe step-up therapy in patients with UC the first year after failing on 5-ASA or corticosteroids. Methods : A Belgian, multi-center, prospective, non-interventional observational study comprising adult UC patients failing on 5-ASA or corticosteroids and naive to immunomodulators/biologicals. During a 12 months follow-up, patient characteristics, demography, medical therapy, biomarkers, therapy adherence and quality of life (QoL) were assessed. Results : After 1 year, 35% of the patients were on biological therapy. Use of anti-TNF; differed depending on baseline treatment: corticosteroid-refractory patients (55.8%), 5-ASA refractory (20.0%), and corticosteroid-dependent (16.0%) patients (p<0.001). The decision to start a line of therapy was based on the Mayo combined severity but not on biomarkers like faecal calprotectin, haemoglobin, CRP, albumin, platelets, and number of extra-intestinal manifestations. At year 1, 84.2% of the patients had only mild CC or remission and a significant improvement of fatigue (p=0.004) and IBDQ scores (p<0.001) were observed implying an improved QoL. Conclusion : Treatment step-up, based on clinical scores in immunomodulatory and anti-TNF naive patients with UC, provides good clinical outcomes and QoL. | Keywords: | step-up therapy;immunomodulators;anti-TNF;clinical scores | Document URI: | http://hdl.handle.net/1942/34527 | ISSN: | 1784-3227 | e-ISSN: | 1784-3227 | ISI #: | WOS:000487985600003 | Category: | A1 | Type: | Journal Contribution |
Appears in Collections: | Research publications |
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