Self-Reported Frequency and Severity of Disease Flares, Disease Perception, and Flare Treatments in Patients With Ulcerative Colitis: Results of a National Internet-Based Survey

Objectives: The purpose of this study was to better understand the characteristics and patterns of treatment of flares of ulcerative colitis (UC) from the patient's perspective. A secondary objective was to determine the predictive value of disease characteristics, particularly disease flares, on current use of biologic therapy. Methods: Study participants were recruited from an Internet panel of self-identified individuals with inflammatory bowel disease (UC or Crohn's disease). The present analysis was limited to individuals who reported having a diagnosis of UC, were aged 48 years, resided in the United States, and could speak and write English. Cross-sectional data (demographic characteristics, insurance coverage, incidence of flares, patient experiences, treatment patterns) were collected via a self-reported Internet-based questionnaire during the third quarter of 2008. Results: A total of 505 individuals with UC completed the survey (72.7% female; 16.6% non-white; 37.2% college graduates; mean [SD] age, 48.6 (2.8] years). The mean time since the diagnosis of UC was 11.9 (10.1.) years, and 76.6% of respondents characterized their disease as controlled. Overall, 27.9% of the sample reported >= 1. flare per week, and an additional 25.1% reported >= 1 flare per month. Most disease flares (76.5%) lasted <= 7 days and were classified as moderate in severity (51.9%). Among those reporting >= 1 flare per week, 30.5% classified their overall disease severity as mild, 56.0% as moderate, and 13.5% as severe. The majority of respondents with >= 1 flare per week currently used 5-aminosalicylic acids (5-ASAs) (41.1%) or corticosteroids (49.6%), whereas 19.1% used immunomodulators and 17.0% used biologics. Disease flares were most commonly treated by increasing the dose of the current medication (60.4%) or adding a corticosteroid to the treatment regimen (34.5%). Conclusions: More than half of these individuals with UC reported experiencing disease flares >= 1 time per week or month. The majority reported using 5-ASAs or corticosteroids as maintenance medications and increasing the dose or adding corticosteroids to control flares in the short term. (Clin Ther. 2010; 32:238-245) (C) 2010 Excerpta Medica Inc.