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HomeUncontrolled UCWhy Patients SettlePrevalence & ImpactDisease NavigatorResources
The prevalence and impact of uncontrolled UC Patients with UC frequently experience ongoing symptoms on conventional therapies or lose response over time.2-4

of patients on conventional therapy reported ongoing symptoms of rectal bleeding*2

of patients on 5-aminosalicylates
(5-ASA) maintenance therapy failed
to maintain clinical or endoscopic remission at 6–12 months†3

of patients with moderate
to severe UC had significant worsening of UC or onset of
acute symptoms after initiating immunomodulating therapy
(mean of ~5 months)‡4

References*The UC-CARES study was an observational, multinational, multicentre, retrospective chart review including cross-sectional collection of patient-reported outcomes from patients with UC (N=150) carried out in 11 European countries.2
†Analysis of 10 studies with a total of 3,910 participants who received once daily 5-ASA.3
‡Retrospective analysis of claims data from the PharMetrics database, which included integrated claims information from 95 managed care health plans spanning all 4 United States Census regions and covering more than 61 million unique patients from 1997 to 2010. 2,136 patients were included.4
Corticosteroid (CS) reliance or excessive use is common and often avoidable in patients with UC.5 References§Steroid dependency or excess was defined as the presence during the preceding 12-month period of ≥1 of: the prescription of >1 steroid course; the inability to wean steroids below 10 mg QD prednisolone or 3 mg QD budesonide within 3 months of initiation; or disease flare within 3 months of stopping steroids. To determine the extent to which doctors had sought to avoid steroid dependency or excess, a standardised list of potential reasons for dependency or excess was agreed and each reason was allocated to 1 of 4 sections: 1) non-inflammatory bowel disease (IBD) prescribing; 2) prescribing where no alternative existed or where appropriate preventative measures were taken; 3) prescribing where relevant alternatives were suboptimally explored; or 4) prescribing where relevant alternatives were not explored. For all cases, meeting the criteria for steroid dependency or excess, relevant clinic letters, biochemical parameters and endoscopy reports were collated and anonymised before being centrally allocated for blinded peer review by a co-author from a different centre, who assigned each case to 1 of 4 pre-agreed categories using a scoring template.5
Data were collected from unselected consecutive IBD patients attending outpatient clinics over 3 months in July–September 2015. Data were obtained for a total of 1,176 patients; 567 (48%) were diagnosed with Crohn's disease (CD), 575 (49%) with UC and 34 (3%) from IBD-unclassified.5
A substantial proportion of patients with IBD are not prescribed advanced therapies despite being appropriate for treatment, according to study criteria.6 References**Criteria applied to identify patients with IBD who are potentially appropriate for advanced therapies include patients with steroid-refractory active disease, patients with steroid dependency, patients with intolerance or contraindication to conventional therapies and/or patients with severe disease that has relapsed.6
††Retrospective observational study; data were collected from Italian Healthcare Departments’ administrative databases. The study sample covered approximately 11.3% of the overall Italian population; 26,781 patients diagnosed with IBD were identified, considering all available periods in the database.6
Find the resources to help look behind “OK” Resources LoadingReferences:References: 
1.  Rubin OT et al. lnflamm Bowel Dis 2017;23:494-501.
2. Peyrin-Biroulet Let al. Dig Liver Dis 2016;48:601-607.
3. Murray A et al. Cochrane Database Syst Rev 2020;8:C0000544.
4. Loftus EV et al. lnflamm Bowel Dis 2014;20:1361-1367.
5. Selinger CP et al. Aliment Pharmacol Ther 2017;46:964-973.
6. Esposti LO et al. Dig Liver Dis 2023. doi:10.1016/j.dld.2023.04.022.
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References:References: 
1.  Rubin OT et al. lnflamm Bowel Dis 2017;23:494-501.
2. Peyrin-Biroulet Let al. Dig Liver Dis 2016;48:601-607.
3. Murray A et al. Cochrane Database Syst Rev 2020;8:C0000544.
4. Loftus EV et al. lnflamm Bowel Dis 2014;20:1361-1367.
5. Selinger CP et al. Aliment Pharmacol Ther 2017;46:964-973.
6. Esposti LO et al. Dig Liver Dis 2023. doi:10.1016/j.dld.2023.04.022.

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