What Do Ulcerative Colitis Patients Prefer in Their Treatments?

Over the past decades, therapeutic options for ulcerative colitis patients have expanded considerably, creating new challenges for both patients and physicians when deciding on treatment. A recent study conducted at Leiden University in the Netherlands investigated what priorities  ulcerative colitis (UC) patients have when choosing a treatment and at what point they would consider surgery after failing multiple treatment options, with the understanding that the decision is based on the clinical judgment of the healthcare professional.

What was investigated in this study?

The study included 172 adult patients with UC, who were asked to choose between different hypothetical treatment options based on several attributes:

• The route and site of administration (oral, subcutaneous injection, or intravenous infusion).
• The likelihood of short- and long-term symptom reduction (over eight weeks or one year).
• Risk of infections and other adverse effects.

Key findings: What matters most to patients?

Patients indicated that the most important feature when choosing a treatment was the reduction in symptoms after one year (27.7% importance). In second place, they mentioned the likelihood of infection (22.3%), and in third place, symptoms reduction in in the first eight weeks (19.5%).

In addition, it was found that:

• The route of administration is also an important factor, with preference for oral administration over subcutaneous or intravenous administration.

• 14.3 % of patients stated that they would not consider surgery, even if they failed eight medical treatments.
• Only 9 patients would opt for surgery, without trying any medical therapy.

In summary, the study highlights that long-term symptom reduction is the most important factor for UC patients when selecting a treatment, above adverse effects or route of administration. In addition, patients with no prior experience with biologics or small molecules were more likely to value route of administration compared to those with experience with these treatments.

Why is this study important?

These findings help clinicians understand what UC patients value most when choosing their treatment. Knowing that long-term symptom reduction is the top priority allows for the design of strategies that ensure individual preferences are taken into account to optimize treatment adherence and patient quality of life.

In conclusion, this study highlights the importance of prioritizing treatments with high long-term effectiveness and lower risk of infections as well as oral treatments. By better understanding patients’ preferences, clinicians can make decisions together with patients, ensuring a more appropriate and satisfactory treatment.

Reference

1. Tessa Straatmijer , M. Elske van den Akker -van Marle , Cyriel Y. Ponsioen , Danielle van der Horst , Menne PM. Scherpenzeel , Marjolijn Duijvestein & Andrea E. van der Meulen -de Jong (2024) Patient preferences in treatment options of ulcerative colitis: a discrete choice experiment , Scandinavian Journal of Gastroenterology , 59:3, 288-295, https://doi.org/10.1080/00365521.2023.2286191