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Consensus recommendations for patient-centered therapy in mild-to-moderate ulcerative colitis: the i Support Therapy–Access to Rapid Treatment (iSTART) approach
Intestinal Research ; : 522-528, 2018.
Article in English | WPRIM | ID: wpr-717953
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.
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Full text: Available Index: WPRIM (Western Pacific) Main subject: Self-Assessment / Ulcer / Colitis, Ulcerative / Epidemiology / Adrenal Cortex Hormones / Patient-Centered Care / Mesalamine / Budesonide / Delivery of Health Care / Consensus Type of study: Practice guideline Limits: Humans Language: English Journal: Intestinal Research Year: 2018 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Self-Assessment / Ulcer / Colitis, Ulcerative / Epidemiology / Adrenal Cortex Hormones / Patient-Centered Care / Mesalamine / Budesonide / Delivery of Health Care / Consensus Type of study: Practice guideline Limits: Humans Language: English Journal: Intestinal Research Year: 2018 Type: Article