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 25 May 2018

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News

Adherence issues in the treatment of ulcerative colitis

The recent issue of Alimentary Pharmacology & Therapeutics examines the impact of non-adherence to 5-aminosalicylic acid among patients with ulcerative colitis, and drug strategies that may improve adherence and clinical outcomes.

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Ulcerative colitis is a chronic inflammatory and debilitating disease requiring lifelong treatment.

First-line therapy for ulcerative colitis is 5-aminosalicylic acid, which suffers from poor patient adherence outside the clinical trial setting.

To deliver 5-aminosalicylic acid to the disease activity site, both orally and topically, is often inconvenient and requires multiple daily dosing.

Such regimens can interfere with normal life and reduce the overall quality of life.

This negatively impacts on treatment adherence and leads to poorer long-term outcomes.

The poorer long-term outcomes include increased morbidity with an elevated risk of symptomatic relapse, possible greater risk of colorectal cancer and higher overall costs of care.

Dr Kane from Chicago searched the literature to determine key factors that influence adherence.

Tablet quantity and dose frequency were key negative influencers of adherence
Alimentary Pharmacology & Therapeutics

The researcher found that ulcerative colitis patients cite treatment regimen complexity as a negative influencer of adherence.

Tablet quantity and dose frequency were also key negative influencers of adherence.

Solutions to these issues include addressing patient concerns, and simplifying daily regimens.

Utilizing new formulations as micropellet and multimatrix oral formulations, rectal gel and once-daily suppository formulations would also be solutions.

Dr Kane concluded, “This review examines the prevalence and impact of non-adherence to 5-aminosalicylic acid therapy among patients with ulcerative colitis.”

“The review also examines drug delivery strategies that may enhance dosing regimens to improve patient acceptability, adherence and long-term clinical outcomes.”

“It is a combination of understanding patient behaviour, recognizing signs of non-adherent behaviour and utilizing management strategies to change behaviour that will improve patient outcomes.”

Aliment Pharmacol Ther 2006: 23(5): 577
28 February 2006

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