Treatment of new-onset ulcerative colitis and ulcerative proctitis: a retrospective study
Alimentary Pharmacology and Therapeutics, 06/29/2012
Richter JM et al. – Oral 5–ASAs 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.Methods
- Using a large US health insurance database, they identified all persons with new–onset UC or UP between 1 January 2005 and 31 December 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 Crohn's disease.
- They examined patterns of pharmacotherapy over 1 year.
- They identified 1516 UC patients and 636 UP patients who met study entry criteria. In UC, initial therapies most frequently used were oral 5–ASAs (53% of patients), oral 5–ASAs and systemic steroids (12%), systemic steroids (8%) and mesalazine suppositories (6%); in UP, mesalazine suppositories (42%) and oral 5–ASAs (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.