Premium
Treatment of new‐onset ulcerative colitis and ulcerative proctitis: a retrospective study
Author(s) -
Richter J. M.,
Kushkuley S.,
Barrett J. A.,
Oster G.
Publication year - 2012
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2012.05175.x
Subject(s) - ulcerative colitis , medicine , proctitis , gastroenterology , retrospective cohort study , dermatology , disease
Summary Background Although guidelines recommend use of oral 5‐aminosalicylates (5‐ ASA s) as first‐line therapy in patients with mild to moderate ulcerative colitis ( UC ) and ulcerative proctitis ( UP ) and steroids with or without 5‐ ASA s in those more severely ill, little is known about how UC and UP are actually treated. Aim To document treatment of new‐onset UC and UP in routine clinical practice. Methods Using a large US health insurance database, we identified all persons with new‐onset UC or UP between 1 J anuary 2005 and 31 D ecember 2007, based on: (i) initial receipt of an oral 5– ASA , mesalazine (mesalamine) suppository, 5‐ ASA enema, steroid, antimetabolite, budesonide or TNF inhibitor; (ii) sigmoidoscopy/colonoscopy in prior 30 days resulting in a new diagnosis of UC or UP and (iii) no prior encounters for C rohn's disease. We examined patterns of pharmacotherapy over 1 year. Results We identified 1516 UC patients and 636 UP patients who met study entry criteria. In UC , initial therapies most frequently used were oral 5‐ ASA s (53% of patients), oral 5‐ ASA s and systemic steroids (12%), systemic steroids (8%) and mesalazine suppositories (6%); in UP , mesalazine suppositories (42%) and oral 5‐ ASA s (19%) were most often used, followed by combination therapy (14%), mesalazine enema (11%) and rectal steroids (10%). Few patients received maintenance therapy, and there was limited use of antimetabolites and biological agents. Conclusions Oral 5‐ ASA s and systemic steroids are the mainstay of treatment in patients with new‐onset ulcerative colitis ; in those with new‐onset ulcerative proctitis , it is mesalazine suppositories. Care of these patients appears consistent with treatment guidelines.