Alessandro Armuzzi, Silvio Danese, Manuel Barreiro-de Acosta, Peter Hur, Lauren Bartolome, Karolina Wosik, Hannah Knight, Vanda Palace, Laurent Peyrin-Biroulet
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引用次数: 0
Abstract
Background: Treatment guidance and real-world data assessing the management and burden of isolated proctitis (IP) are limited.
Objective: We aimed to understand disease burden in ulcerative colitis (UC) patients with different degrees of disease extension, focusing on IP.
Design: A cross-sectional survey, with retrospective data collection, of physicians and their consulting patients was conducted in France, Germany, Italy, Spain, the United Kingdom, and the United States between January 2020 and March 2021.
Methods: Data were drawn from the Adelphi Real World UC Disease Specific Programme™. Physicians reported clinical presentation and treatment history for patients with UC. Patients were stratified according to their disease extension into IP (non-refractory (never received an immunomodulator (IM)/advanced therapy (AT)) or refractory (received an IM/AT)) and more extensive UC (MEUC) groups. Analyses were descriptive.
Results: Among patients with IP (n = 221) and MEUC (n = 1607), respectively, the most common symptoms were abdominal pain (33.8% and 26.0%), bowel urgency (22.7% and 23.6%), and fatigue (22.7% and 23.8%). Physicians also commonly reported passing mucus (19.0%), tenesmus (15.7%), and rectal bleeding (15.3%) among patients with IP. Following diagnosis, 21.3% of IP and 42.8% of MEUC patients had received an IM, and 33.5% of IP and 68.9% of MEUC patients had received an AT. According to derived total Mayo scores, at consultation, 40.3% (95% confidence interval: 33.7, 47.1) of IP and 50.4% (47.9, 52.9) of MEUC patients were in remission; the lowest proportion of patients in remission was among refractory IP patients (35.0% (25.8, 45.0)).
Conclusion: Patients with IP experienced a range of symptoms, with many requiring treatment beyond the guideline-recommended first-line conventional therapies. In addition, the majority of IP patients with IM and/or AT experience were not in remission.
背景：评估孤立性直肠炎（IP）管理和负担的治疗指导和实际数据是有限的。目的：了解不同疾病延伸程度的溃疡性结肠炎（UC）患者的疾病负担，以IP为重点。设计：在2020年1月至2021年3月期间，对法国、德国、意大利、西班牙、英国和美国的医生及其咨询患者进行了一项回顾性数据收集的横断面调查。方法：数据来自Adelphi Real World UC Disease Specific program™。医生报告了UC患者的临床表现和治疗史。根据病情扩展将患者分为IP(非难治性（从未接受过免疫调节剂（IM)/高级治疗（AT））或难治性（接受过IM/AT））和更广泛的UC （MEUC）组。分析是描述性的。结果：在IP （n = 221）和MEUC （n = 1607）患者中，最常见的症状是腹痛（33.8%和26.0%）、肠急症（22.7%和23.6%）和疲劳（22.7%和23.8%）。在IP患者中，医生也经常报告有粘液排出（19.0%）、下坠（15.7%）和直肠出血（15.3%）。诊断后，21.3%的IP和42.8%的MEUC患者接受了IM， 33.5%的IP和68.9%的MEUC患者接受了AT。根据导出的Mayo总分，在会诊时，40.3%（95%可信区间：33.7,47.1）的IP患者和50.4%（47.9,52.9）的MEUC患者缓解；缓解的患者比例最低的是难治性IP患者（35.0%(25.8,45.0)）。结论：IP患者出现一系列症状，许多患者需要超出指南推荐的一线常规治疗。此外，大多数有IM和/或AT经历的IP患者没有缓解。
期刊介绍：
Therapeutic Advances in Gastroenterology is an open access journal which delivers the highest quality peer-reviewed original research articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of gastrointestinal and hepatic disorders. The journal has a strong clinical and pharmacological focus and is aimed at an international audience of clinicians and researchers in gastroenterology and related disciplines, providing an online forum for rapid dissemination of recent research and perspectives in this area.
The editors welcome original research articles across all areas of gastroenterology and hepatology.
The journal publishes original research articles and review articles primarily. Original research manuscripts may include laboratory, animal or human/clinical studies – all phases. Letters to the Editor and Case Reports will also be considered.
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