Consensus recommendations for patient-centered therapy in mild-to-moderate ulcerative colitis: the i Support Therapy–Access to Rapid Treatment (iSTART) approach.
- Author:
Silvio DANESE
1
;
Rupa BANERJEE
;
JR Fraser CUMMINGS
;
Iris DOTAN
;
Paulo G KOTZE
;
Rupert Wing Loong LEONG
;
Kristine PARIDAENS
;
Laurent PEYRIN-BIROULET
;
Glyn SCOTT
;
Gert Van ASSCHE
;
Jan WEHKAMP
;
Jesús K YAMAMOTO-FURUSHO
Author Information
- Publication Type:Review
- Keywords: Colitis, ulcerative; Consensus guidelines; Mesalazine; Corticosteroids; Patient reported outcome measures
- MeSH: Adrenal Cortex Hormones; Budesonide; Colitis, Ulcerative*; Consensus*; Delivery of Health Care; Epidemiology; Humans; Mesalamine; Patient-Centered Care; Self-Assessment; Ulcer*
- From:Intestinal Research 2018;16(4):522-528
- CountryRepublic of Korea
- Language:English
- Abstract: 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.
