Introduction National and multi-national bodies provide guidance for the treatment of mild-moderate Ulcerative Colitis (UC). How these recommendations are applied in clinical practice is unclear. Very limited data on real-life prescriptions by gastroenterologists are available.
Method In November 2015, 181 gastroenterologists from 8 EU countries [Czech Republic (CZ): 31 (17%); Denmark (DK): 20 (11%); Finland (FI): 12 (7%); France (FR): 30 (17%); Ireland (IE): 15 (8%); Norway (NO): 11 (6%); Spain (ES): 31 (17%); Sweden (SE): 31 (17%)] were invited to participate in an online survey. The analysis was explorative in nature and descriptive results are presented.
Results Participating physicians reported seeing and treating on average of 25–71 patients with UC of different severity per month. Of these, 9%–22% were treatment naïve, 21%–41% were relapsing, and 43%–64% were in remission. Overall, mesalazine (5-ASA) was the treatment of choice in 72%–97% for patients with mild UC and in 67%–95% with moderate UC, while 6%–44% and 41%–83% of patients with mild and moderate UC were on a combination therapy.
Interestingly, 3%–10% of physicians in ES, IE and DK and 3%–9% of physicians in ES and NO prescribed corticosteroids and/or biologics/biosimilars for newly diagnosed patients with mild disease. The mean mesalazine daily dose for induction/maintenance of remission was of 3.9/2.4g in DK; 3.5/2.1g in SE; 3.5/1.8g in NO; 3.5/1.9g in CZ; 3.4/2.3g in IE; 3.1/2.1g in FI; and 2.4/1.3g in ES.
In case of relapse, 48%–68% of the participating physicians increased the treatment dose, 17%–55% added another therapy while 5%–17% switched to another therapy. In case of add-on therapy, 25%–68% of physicians prescribed corticosteroids, 9%–33% biologics, 3%–20% biosimilars, and 10%–50% azathiopirine. In case of switch to another therapy, 8%–60% of physicians prescribed corticosteroids, 3%–33% biologics, 9%–17% biosimilars, and 5%–58% azathiopirine.
Physicians’ perception of patients’ compliance varied among countries, from a minimum of 40% in CZ to a maximum of 77% in ES.
Conclusion Several factors, including personalised treatment and the local reimbursement scheme might influence prescription behaviour in different countries. Prescription of corticosteroids and biologics/biosimilars for newly diagnosed patients with mild form of the disease is difficult to explain and might mirror local medical habits or indicate a need for further education.
Disclosure of Interest P. Marchi Conflict with: Tillotts Pharma AG, B. Chemittz-Nielsen Conflict with: TNF-Sifo Navigare
- Prescription behaviour
- Real life