Background: Treatment guidance and real-world data assessing the management and burden of isolated proctitis (IP) are limited. Objective: We aimed to understand disease burden in ulcerative colitis (UC) patients with different degrees of disease extension, focusing on IP. Design: A cross-sectional survey, with retrospective data collection, of physicians and their consulting patients was conducted in France, Germany, Italy, Spain, the United Kingdom, and the United States between January 2020 and March 2021. Methods: Data were drawn from the Adelphi Real World UC Disease Specific Programme™. Physicians reported clinical presentation and treatment history for patients with UC. Patients were stratified according to their disease extension into IP (non-refractory (never received an immunomodulator (IM)/advanced therapy (AT)) or refractory (received an IM/AT)) and more extensive UC (MEUC) groups. Analyses were descriptive. Results: Among patients with IP ( n = 221) and MEUC ( n = 1607), respectively, the most common symptoms were abdominal pain (33.8% and 26.0%), bowel urgency (22.7% and 23.6%), and fatigue (22.7% and 23.8%). Physicians also commonly reported passing mucus (19.0%), tenesmus (15.7%), and rectal bleeding (15.3%) among patients with IP. Following diagnosis, 21.3% of IP and 42.8% of MEUC patients had received an IM, and 33.5% of IP and 68.9% of MEUC patients had received an AT. According to derived total Mayo scores, at consultation, 40.3% (95% confidence interval: 33.7, 47.1) of IP and 50.4% (47.9, 52.9) of MEUC patients were in remission; the lowest proportion of patients in remission was among refractory IP patients (35.0% (25.8, 45.0)). Conclusion: Patients with IP experienced a range of symptoms, with many requiring treatment beyond the guideline-recommended first-line conventional therapies. In addition, the majority of IP patients with IM and/or AT experience were not in remission.
Armuzzi et al. (Fri,) studied this question.