P461 Therapeutic requirements and health resources in the treatment of clinically active ulcerative proctitis
C. Margalida*, M. Larrain, N. Caballero, M. Mañosa, T. Labaton, L. Marin, E. Cabre, E. Domenech
Hospital Universitari Germans Trias i Pujol and CIBERehd, Gastroenterology, Badalona, Spain
In population-based studies, ulcerative proctitis (UP) accounts for more than 25% of of ulcerative colitis (UC) patients and presents clinical, distinctive clinical outcomes and therapeutic approaches as compared to left-sided and extensive UC. Aim: To describe the clinical outcomes, therapeutic requirements and the use of health resources for treatment of active UP.
We identified all the patients with UC limited to the rectum as maximum disease extent. Clinical information was recorded including patients' evolution and treatments provided for each episode, specifying galenical drug used.
Out of 687 patients with UC, 101 (15%) had UP, with no further evidence of proximal progression. Median age at diagnosis was 38 years (IQR 29-49), average time of follow up was 8 years (3-14). The most common treatment schedule for disease activity was topical 5ASA in monotehrapy in 66% (mostly suppositories), followed by oral 5ASA monotherapy in 33% of patients, whereas 30% of patients were managed with combination therapy (oral+topical, topical+topical). Steroids were used topically in 26% of cases: In 8% of cases oral prednisone was used, and 10% used oral beclomethasone (mostly only one course per patient). Only 4% required hospital admission due to UP activity.
Active UP requires a low use of healthcare resources. In clinical practice, 5ASA suppositories are the most used treatment, suggesting a high degree of confidence by prescribers. However, oral 5ASA, topical corticosteroids and combination of any of them, are also frequently used for the management of active UP.