Combination of corticosteroids and 5-aminosalicylates or corticosteroids alone for patients with moderate-severe active ulcerative colitis

A global survey of physicians' practice

Shomron Ben-Horin, Jane M. Andrews, Konstantinos H. Katsanos, Florian Rieder, Flavio Steinwurz, Konstantinos Karmiris, JaeHee Cheon, Gordon William Moran, Monica Cesarini, Christian D. Stone, Doron Schwartz, Marijana Protic, Xavier Roblin, Giulia Roda, Min Hu Chen, Ofir Har-Noy, Charles N. Bernstein

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Aim: To examine treatment decisions of gastroenterologists regarding the choice of prescribing 5-aminosalycilates (5ASA) with corticosteroids (CS) versus corticosteroids alone for patients with active ulcerative colitis (UC). Methods: A cross-sectional questionnaire exploring physicians' attitude toward 5ASA + CS combination therapy vs CS alone was developed and validated. The questionnaire was distributed to gastroenterology experts in twelve countries in five continents. Respondents' agreement with stated treatment choices were assessed by standardized Likert scale. Background professional characteristics of respondents were analyzed for correlation with responses. Results: Six hundred and sixty-four questionnaires were distributed and 349 received (52.6% response rate). Of 340 eligible respondents, 221 (65%) would continue 5ASA in a patient hospitalized for intravenous CS treatment due to a moderate-severe UC flare, while 108 (32%) would stop the 5ASA (P < 0.001), and 11 (3%) are undecided. Similarly, 62% would continue 5ASA in an out-patient starting oral CS. However, only 140/340 (41%) would proactively start 5ASA in a hospitalized patient not receiving 5ASA before admission. Most (94%) physicians consider the safety profile of 5ASA as very good. Only 52% consider them inexpensive, 35% perceive them to be expensive and 12% are undecided. On multi-variable analysis, less years of practice and perception of a plausible additive mechanistic effect of 5ASA + CS were positively associated with the decision to continue 5ASA with CS. Conclusion: Despite the absence of data supporting its benefit, most gastroenterologists endorse combination of 5ASA + CS for patients with active moderate-to-severe UC. Randomized controlled trials are needed to assess if 5ASA confer any benefit for these patients.

Original languageEnglish
Pages (from-to)2995-3002
Number of pages8
JournalWorld Journal of Gastroenterology
Volume23
Issue number16
DOIs
Publication statusPublished - 2017 Apr 28

Fingerprint

Mesalamine
Ulcerative Colitis
Adrenal Cortex Hormones
Physicians
Surveys and Questionnaires
Gastroenterology
Therapeutics
Outpatients
Randomized Controlled Trials
Safety

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Ben-Horin, Shomron ; Andrews, Jane M. ; Katsanos, Konstantinos H. ; Rieder, Florian ; Steinwurz, Flavio ; Karmiris, Konstantinos ; Cheon, JaeHee ; Moran, Gordon William ; Cesarini, Monica ; Stone, Christian D. ; Schwartz, Doron ; Protic, Marijana ; Roblin, Xavier ; Roda, Giulia ; Chen, Min Hu ; Har-Noy, Ofir ; Bernstein, Charles N. / Combination of corticosteroids and 5-aminosalicylates or corticosteroids alone for patients with moderate-severe active ulcerative colitis : A global survey of physicians' practice. In: World Journal of Gastroenterology. 2017 ; Vol. 23, No. 16. pp. 2995-3002.
@article{351140252c1945b0871986cd4e1ff3e1,
title = "Combination of corticosteroids and 5-aminosalicylates or corticosteroids alone for patients with moderate-severe active ulcerative colitis: A global survey of physicians' practice",
abstract = "Aim: To examine treatment decisions of gastroenterologists regarding the choice of prescribing 5-aminosalycilates (5ASA) with corticosteroids (CS) versus corticosteroids alone for patients with active ulcerative colitis (UC). Methods: A cross-sectional questionnaire exploring physicians' attitude toward 5ASA + CS combination therapy vs CS alone was developed and validated. The questionnaire was distributed to gastroenterology experts in twelve countries in five continents. Respondents' agreement with stated treatment choices were assessed by standardized Likert scale. Background professional characteristics of respondents were analyzed for correlation with responses. Results: Six hundred and sixty-four questionnaires were distributed and 349 received (52.6{\%} response rate). Of 340 eligible respondents, 221 (65{\%}) would continue 5ASA in a patient hospitalized for intravenous CS treatment due to a moderate-severe UC flare, while 108 (32{\%}) would stop the 5ASA (P < 0.001), and 11 (3{\%}) are undecided. Similarly, 62{\%} would continue 5ASA in an out-patient starting oral CS. However, only 140/340 (41{\%}) would proactively start 5ASA in a hospitalized patient not receiving 5ASA before admission. Most (94{\%}) physicians consider the safety profile of 5ASA as very good. Only 52{\%} consider them inexpensive, 35{\%} perceive them to be expensive and 12{\%} are undecided. On multi-variable analysis, less years of practice and perception of a plausible additive mechanistic effect of 5ASA + CS were positively associated with the decision to continue 5ASA with CS. Conclusion: Despite the absence of data supporting its benefit, most gastroenterologists endorse combination of 5ASA + CS for patients with active moderate-to-severe UC. Randomized controlled trials are needed to assess if 5ASA confer any benefit for these patients.",
author = "Shomron Ben-Horin and Andrews, {Jane M.} and Katsanos, {Konstantinos H.} and Florian Rieder and Flavio Steinwurz and Konstantinos Karmiris and JaeHee Cheon and Moran, {Gordon William} and Monica Cesarini and Stone, {Christian D.} and Doron Schwartz and Marijana Protic and Xavier Roblin and Giulia Roda and Chen, {Min Hu} and Ofir Har-Noy and Bernstein, {Charles N.}",
year = "2017",
month = "4",
day = "28",
doi = "10.3748/wjg.v23.i16.2995",
language = "English",
volume = "23",
pages = "2995--3002",
journal = "World Journal of Gastroenterology",
issn = "1007-9327",
publisher = "WJG Press",
number = "16",

}

Ben-Horin, S, Andrews, JM, Katsanos, KH, Rieder, F, Steinwurz, F, Karmiris, K, Cheon, J, Moran, GW, Cesarini, M, Stone, CD, Schwartz, D, Protic, M, Roblin, X, Roda, G, Chen, MH, Har-Noy, O & Bernstein, CN 2017, 'Combination of corticosteroids and 5-aminosalicylates or corticosteroids alone for patients with moderate-severe active ulcerative colitis: A global survey of physicians' practice', World Journal of Gastroenterology, vol. 23, no. 16, pp. 2995-3002. https://doi.org/10.3748/wjg.v23.i16.2995

Combination of corticosteroids and 5-aminosalicylates or corticosteroids alone for patients with moderate-severe active ulcerative colitis : A global survey of physicians' practice. / Ben-Horin, Shomron; Andrews, Jane M.; Katsanos, Konstantinos H.; Rieder, Florian; Steinwurz, Flavio; Karmiris, Konstantinos; Cheon, JaeHee; Moran, Gordon William; Cesarini, Monica; Stone, Christian D.; Schwartz, Doron; Protic, Marijana; Roblin, Xavier; Roda, Giulia; Chen, Min Hu; Har-Noy, Ofir; Bernstein, Charles N.

In: World Journal of Gastroenterology, Vol. 23, No. 16, 28.04.2017, p. 2995-3002.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Combination of corticosteroids and 5-aminosalicylates or corticosteroids alone for patients with moderate-severe active ulcerative colitis

T2 - A global survey of physicians' practice

AU - Ben-Horin, Shomron

AU - Andrews, Jane M.

AU - Katsanos, Konstantinos H.

AU - Rieder, Florian

AU - Steinwurz, Flavio

AU - Karmiris, Konstantinos

AU - Cheon, JaeHee

AU - Moran, Gordon William

AU - Cesarini, Monica

AU - Stone, Christian D.

AU - Schwartz, Doron

AU - Protic, Marijana

AU - Roblin, Xavier

AU - Roda, Giulia

AU - Chen, Min Hu

AU - Har-Noy, Ofir

AU - Bernstein, Charles N.

PY - 2017/4/28

Y1 - 2017/4/28

N2 - Aim: To examine treatment decisions of gastroenterologists regarding the choice of prescribing 5-aminosalycilates (5ASA) with corticosteroids (CS) versus corticosteroids alone for patients with active ulcerative colitis (UC). Methods: A cross-sectional questionnaire exploring physicians' attitude toward 5ASA + CS combination therapy vs CS alone was developed and validated. The questionnaire was distributed to gastroenterology experts in twelve countries in five continents. Respondents' agreement with stated treatment choices were assessed by standardized Likert scale. Background professional characteristics of respondents were analyzed for correlation with responses. Results: Six hundred and sixty-four questionnaires were distributed and 349 received (52.6% response rate). Of 340 eligible respondents, 221 (65%) would continue 5ASA in a patient hospitalized for intravenous CS treatment due to a moderate-severe UC flare, while 108 (32%) would stop the 5ASA (P < 0.001), and 11 (3%) are undecided. Similarly, 62% would continue 5ASA in an out-patient starting oral CS. However, only 140/340 (41%) would proactively start 5ASA in a hospitalized patient not receiving 5ASA before admission. Most (94%) physicians consider the safety profile of 5ASA as very good. Only 52% consider them inexpensive, 35% perceive them to be expensive and 12% are undecided. On multi-variable analysis, less years of practice and perception of a plausible additive mechanistic effect of 5ASA + CS were positively associated with the decision to continue 5ASA with CS. Conclusion: Despite the absence of data supporting its benefit, most gastroenterologists endorse combination of 5ASA + CS for patients with active moderate-to-severe UC. Randomized controlled trials are needed to assess if 5ASA confer any benefit for these patients.

AB - Aim: To examine treatment decisions of gastroenterologists regarding the choice of prescribing 5-aminosalycilates (5ASA) with corticosteroids (CS) versus corticosteroids alone for patients with active ulcerative colitis (UC). Methods: A cross-sectional questionnaire exploring physicians' attitude toward 5ASA + CS combination therapy vs CS alone was developed and validated. The questionnaire was distributed to gastroenterology experts in twelve countries in five continents. Respondents' agreement with stated treatment choices were assessed by standardized Likert scale. Background professional characteristics of respondents were analyzed for correlation with responses. Results: Six hundred and sixty-four questionnaires were distributed and 349 received (52.6% response rate). Of 340 eligible respondents, 221 (65%) would continue 5ASA in a patient hospitalized for intravenous CS treatment due to a moderate-severe UC flare, while 108 (32%) would stop the 5ASA (P < 0.001), and 11 (3%) are undecided. Similarly, 62% would continue 5ASA in an out-patient starting oral CS. However, only 140/340 (41%) would proactively start 5ASA in a hospitalized patient not receiving 5ASA before admission. Most (94%) physicians consider the safety profile of 5ASA as very good. Only 52% consider them inexpensive, 35% perceive them to be expensive and 12% are undecided. On multi-variable analysis, less years of practice and perception of a plausible additive mechanistic effect of 5ASA + CS were positively associated with the decision to continue 5ASA with CS. Conclusion: Despite the absence of data supporting its benefit, most gastroenterologists endorse combination of 5ASA + CS for patients with active moderate-to-severe UC. Randomized controlled trials are needed to assess if 5ASA confer any benefit for these patients.

UR - http://www.scopus.com/inward/record.url?scp=85018975741&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85018975741&partnerID=8YFLogxK

U2 - 10.3748/wjg.v23.i16.2995

DO - 10.3748/wjg.v23.i16.2995

M3 - Article

VL - 23

SP - 2995

EP - 3002

JO - World Journal of Gastroenterology

JF - World Journal of Gastroenterology

SN - 1007-9327

IS - 16

ER -