TY - JOUR
T1 - Consensus recommendations for patient-centered therapy in mild-to-moderate ulcerative colitis
T2 - the i Support Therapy-Access to Rapid Treatment (iSTART) approach
AU - Danese, Silvio
AU - Banerjee, Rupa
AU - Cummings, J. R. Fraser
AU - Dotan, Iris
AU - Kotze, Paulo G.
AU - Leong, Rupert Wing Loong
AU - Paridaens, Kristine
AU - Peyrin-Biroulet, Laurent
AU - Scott, Glyn
AU - Van Assche, Gert
AU - Wehkamp, Jan
AU - Yamamoto-Furusho, Jesús K.
N1 - Copyright the Publisher 2018. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.
PY - 2018/10/1
Y1 - 2018/10/1
N2 - Symptomatic ulcerative colitis (UC) can be a chronic, disabling condition. Flares in disease activity are associated with many of the negative impacts of mild-to-moderate UC. Rapid resolution of flares can provide benefits to patients and healthcare systems. i Support Therapy-Access to Rapid Treatment (iSTART) introduces patient-centered care for mild-to-moderate UC. iSTART provides patients with the ability to self-assess symptomology and self-start a short course of second-line treatment when necessary. An international panel of experts produced consensus statements and recommendations. These were informed by evidence from systematic reviews on the epidemiology, mesalazine (5-ASA) treatment, and patient use criteria for second-line therapy in UC. Optimized 5-ASA is the first-line treatment in all clinical guidelines, but may not be sufficient to induce remission in all patients. Corticosteroids should be prescribed as second-line therapy when needed, with budesonide MMX® being a preferred steroid option. Active involvement of suitable patients in management of UC flares has the potential to improve therapy, with patients able to show good accuracy for flare self-assessment using validated tools. There is a place in the UC treatment pathway for an approach such as iSTART, which has the potential to provide patient, clinical and economic benefits.
AB - Symptomatic ulcerative colitis (UC) can be a chronic, disabling condition. Flares in disease activity are associated with many of the negative impacts of mild-to-moderate UC. Rapid resolution of flares can provide benefits to patients and healthcare systems. i Support Therapy-Access to Rapid Treatment (iSTART) introduces patient-centered care for mild-to-moderate UC. iSTART provides patients with the ability to self-assess symptomology and self-start a short course of second-line treatment when necessary. An international panel of experts produced consensus statements and recommendations. These were informed by evidence from systematic reviews on the epidemiology, mesalazine (5-ASA) treatment, and patient use criteria for second-line therapy in UC. Optimized 5-ASA is the first-line treatment in all clinical guidelines, but may not be sufficient to induce remission in all patients. Corticosteroids should be prescribed as second-line therapy when needed, with budesonide MMX® being a preferred steroid option. Active involvement of suitable patients in management of UC flares has the potential to improve therapy, with patients able to show good accuracy for flare self-assessment using validated tools. There is a place in the UC treatment pathway for an approach such as iSTART, which has the potential to provide patient, clinical and economic benefits.
KW - Colitis
KW - Consensus guidelines
KW - Corticosteroids
KW - Mesalazine
KW - Patient reported outcome measures
KW - Ulcerative
UR - http://www.scopus.com/inward/record.url?scp=85056502269&partnerID=8YFLogxK
U2 - 10.5217/ir.2018.00073
DO - 10.5217/ir.2018.00073
M3 - Article
C2 - 30321913
AN - SCOPUS:85056502269
SN - 1598-9100
VL - 16
SP - 522
EP - 528
JO - Intestinal Research
JF - Intestinal Research
IS - 4
ER -