Consensus recommendations for patient-centered therapy in mild-to-moderate ulcerative colitis: the i Support Therapy–Access to Rapid Treatment (iSTART) approach

Intestinal Research

Paulo G Kotze¹  JR Fraser Cummings²  Jan Wehkamp³  Iris Dotan⁴  Glyn Scott⁵  Kristine Paridaens⁶  Rupert Wing Loong Leong⁷  Jesús K Yamamoto-Furusho⁸  Silvio Danese⁹  Rupa Banerjee^1,10  Laurent Peyrin-Biroulet^1,11  Gert Van Assche^1,12 

[1] Colorectal Surgery Unit, Hospital Universitário Cajuru, Pontifical Catholic University of Paraná, Curitiba, Brazil;Department of Gastroenterology, Southampton General Hospital, Southampton, UK;Department of Hepatology, Gastroenterology & Infectious Diseases, University Hospital Tuebingen, Tübingen, Germany;Division of Gastroenterology, Rabin Medical Center, Petah-Tikva, Israel, affiliated with the Sackler Faculty of Medicine, Tel Aviv Israel;East Kent Hospitals Trust, Canterbury, UK;Ferring Pharmaceuticals, Saint-Prex, Switzerland;Gastroenterology and Liver Services, Concord Hospital, Sydney, Australia;IBD Clinic, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición, Mexico City, Mexico;Inflammatory Bowel Disease Clinical and Research Unit, Istituto Clinico Humanitas, Milan, Italy;Inflammatory Bowel Diseases Clinic, Asian Institute of Gastroenterology, Hyderabad, India;Inserm U954, Department of Gastroenterology, Nancy University Hospital, Lorraine University, Vandoeuvre-les-Nancy, France;UZ Leuven, Leuven, Belgium;

关键词: Colitis, ulcerative;    Consensus guidelines;    Mesalazine;    Corticosteroids;    Patient reported outcome measures;   

DOI  :  10.5217/ir.2018.00073

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown