Most ulcerative colitis patients do not achieve target remission

(HealthDay)—Most patients with ulcerative colitis (UC) do not achieve the 'Treat to Target' (T2T) end point of composite clinical and endoscopic remission, according to research published online Aug. 14 in the Journal of Gastroenterology and Hepatology.

Noting that the T2T approach has been proposed for UC, Robert V. Bryant, M.B.B.S., from the University of Adelaide in Australia, and colleagues examined the extent to which proposed targets are achieved in real-world care in a retrospective, cross-sectional review of patients with UC. Gastroenterologists' perceptions of T2T in UC were evaluated using a survey.

The researchers found that 61 percent of 246 patients with UC were in clinical remission, 35 percent were in clinical and endoscopic remission, and 16 percent were in concordant clinical, endoscopic, and histological remission. Clinician-related factors rather than disease-related factors (extent/activity) dominated outcome. Combined clinical and endoscopic remission was predicted by hospital location and the choice of therapy (odds ratios, 3.6 and 3.3, respectively). C-reactive protein was used more often than endoscopy by clinicians as a biomarker for disease activity (75 versus 47 percent). Forty-five of 61 gastroenterologists responded to the survey, with significant disparity between their estimates of targets achieved in practice and real-world data.

"Most patients with UC do not achieve composite clinical and endoscopic remission in 'real-world' practice," the authors write. "Clinician uptake of proposed 'Treat to Target' guidelines is a challenge to their implementation."

Several authors disclosed financial ties to the pharmaceutical industry.

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