Intestinal Research

Original Articles

IBD

Clinical characteristics of patients with difficult-to-treat ulcerative colitis: a nested case-control study using a Japanese claims database: Katsuyoshi Matsuoka, Ataru Igarashi, Noriko Sato, Naomi Mizuno, Manabu Ishii, Masato Iizuka, Katsuhiko Iwasaki, Ayako Shoji, Tadakazu Hisamatsu; Intest Res 2026;24(1):103-116. Published online April 25, 2025; DOI: https://doi.org/10.5217/ir.2024.00119

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Despite the advent of advanced therapies, cases of so-called “difficult-to-treat” (D2T) ulcerative colitis (UC) persist. This study aims to clarify the epidemiological and clinical characteristics of patients with D2T UC.
Methods
We conducted a nested case-control study using the Medical Data Vision Claims Database in patients with UC who began an advanced therapy (biologics, advanced small molecules, calcineurin inhibitors) from January 2018 through April 2023. D2T UC patients were defined as having 2 or more switches of advanced therapies, or as undergoing surgery for UC, within 2 years after the first advanced therapy.
Results
Four hundred and one (16.7%) and 1,996 patients (83.3%) met the definitions of patients with D2T UC and non-D2T UC, respectively. After 1:1 matching by index year, 355 patients per group were included in the analysis. Multivariate logistic regression analyses, including sensitivity analyses based on follow-up period after the first advanced therapy, showed that a prescribed corticosteroid dose of ≥ 30 mg/day during the 6-month baseline period was associated with D2T UC. In D2T UC patients, median duration of the first advanced therapy was 99 days, and median number of advanced therapies per year was 1.7. The first advanced therapy was continued for 2 years in 78% of patients with non-D2T UC.
Conclusions
The proportion of D2T UC patients among UC patients starting advanced therapy was 16.7%. The factor most associated with D2T UC was the need for a corticosteroid dose ≥ 30 mg/day during the 6 months before initiation of advanced therapy.

Citations

Citations to this article as recorded by

Extraintestinal Manifestations and Cytomegalovirus Reactivation Are Predictors of Difficult-To-Treat in Ulcerative Colitis
Kotaro Akita, Mayuko Erata, Yoshihiro Yokoyama, Yuta Shimomori, Tomoe Kazama, Hiroki Kurumi, Masanori Nojima, Hiroshi Nakase
Inflammatory Intestinal Diseases.2025; 11(1): 18. CrossRef

4,895 View
389 Download
1 Crossref

IBD

Patient preferences for advanced therapies in ulcerative colitis using conjoint analysis: Taku Kobayashi, Naomi Mizuno, Noriko Sato, Yutaka Kawaguchi, Yoshiko Ikawa, Naruyasu Komorita, Hirono Ishikawa; Intest Res 2025;23(3):318-337. Published online October 14, 2024; DOI: https://doi.org/10.5217/ir.2024.00101

Abstract PDF PubReader ePub: Background/Aims
Selecting an optimal advanced therapy for ulcerative colitis (UC) is difficult because of the increasing number of available therapies. This study assessed UC patients’ preferences for drug profiles in decision-making regarding advanced therapies using conjoint analysis.
Methods
A web-based survey was conducted from October to November 2023 in patients with UC aged ≥ 18 years with prior oral 5-aminosalicylic acid treatment (UMIN000052327). We quantified the importance of drug attributes (location of administration, route/frequency of administration, speed of onset-of-action, maintenancesustainability, risk of serious adverse events within 1 year, and novelty of the drug) and the part-worth utility of attribute levels in mild and severe symptom scenarios, including among employed versus unemployed patients.
Results
Of 372 patients who completed the survey, 365 were evaluated. Patient preferences were generally highly individualized. The route/frequency of administration was the most important attribute in both the mild and severe symptom scenarios. Oral administration was preferred in the mild symptom scenario, whereas no specific preference was observed in the severe symptom scenario. The route/ frequency of administration was more valued in the mild symptom scenario than in the severe one, whereas speed of onset of action was more valued in the severe symptom scenario. No significant difference was found in the preference for drug profiles between employed and unemployed patients.
Conclusions
Patient preferences for the route/frequency of administration, as well as other drug profiles, change with disease severity but demonstrate substantial interindividual variability. Therefore, shared decision-making is important to incorporate patients’ perspectives into the selection of advanced therapies.

4,941 View
320 Download

First
Prev
Page of 1
Next
Last

Search