Authors:OBJECTIVES: Ulcerative colitis (UC) requires life-long disease management. The study objective was to investigate the burden of UC and unmet medical need in patients who receive advanced (biologic or JAK inhibitor) therapy in Greece.
METHODS: Between October 2023 and January 2024, adult patients who were members of Hellenic Society of Crohn’s disease’s and Ulcerative Colitis’ patients (HELLESCC) filled out a structured self-questionnaire. The survey questionnaire included sociodemographic characteristics, smoking habits, history of comorbidities, disease activity, disease characteristics, IBD medications, and patient-reported outcomes (PROs; Short Inflammatory Bowel Disease Questionnaire [SIBDQ], Work Productivity and Activity Impairment-Specific Health Problem [WPAI-SHP], Patient Health Questionnaire-9 [PHQ-9], treatment satisfaction and treatment adherence).
RESULTS: 86 UC patients receiving a biologic/JAK therapy were included in the analysis (median age 42 years, proportion of female patients 53.5%, median BMI 26, proportion of current smokers 20.9%, median age at diagnosis and disease duration 30 and 11 years, respectively). According to the Simple Clinical Colitis Activity Index (SCCAI) disease activity groups, 41.9% were in remission, 30.2% had mild disease, and 27.9% had moderate/severe disease. Around 76% of patients reported moderately [SIBDQ 45–59: 36.1%] to severely [SIBDQ <45: 40.3%] impaired quality of life. One-tenth reported work productivity loss and 30% reported activity impairment. Around half of patients reported moderate to severe depressive symptoms [PHQ-9≥10: 50.7%]. The 33.7% of the patients were “not at all”, “little” or “quite” satisfied by their biologic/JAK treatment, with the main reason of dissatisfaction to be the “I still have frequent flares”. One-fourth (24.1%) reported reduced adherence. Statistically significant associations were found between PROs and disease activity.
CONCLUSIONS: Despite the use of biologic/JAK therapies, this real-world analysis reveals that the disease burden is very high in UC, with poor quality of life as well as increased work impairment, depression, and disease activity in Greek patients.