Danese Silvio, Allez Matthieu, van Bodegraven Ad A, Dotan Iris, Gisbert Javier P, Hart Ailsa, Lakatos Peter L, Magro Fernando, Peyrin-Biroulet Laurent, Schreiber Stefan, Tarabar Dino, Vavricka Stephan, Halfvarson Jonas, Vermeire Séverine
Humanitas Research Hospital, Milan, Italy.
Department of Gastroenterology and Hepatology, Hôpital Saint-Louis, Paris, France.
Dig Dis. 2019;37(4):266-283. doi: 10.1159/000496739. Epub 2019 Feb 6.
The authors aimed to conduct an extensive literature review and consensus meeting to identify unmet needs in ulcerative colitis (UC) and ways to overcome them. UC is a relapsing and remitting inflammatory bowel disease with varied, and changing, incidence rates worldwide. UC has an unpredictable disease course and is associated with a high health economic burden. During 2016 and 2017, a panel of experts was convened to identify, discuss and address areas of unmet need in UC.
PubMed and Cochrane Library databases were searched for relevant articles describing studies performed in patients with UC. These findings were used to generate a set of statements relating to unmet needs in UC. Consensus on these statements was then sought from a panel of 9 expert gastroenterologists using a modified Delphi review process that consisted of anonymous surveys followed by live meetings.
In 2 literature reviews, over 5,000 unique records were identified and a total of 138 articles were fully reviewed. These were used to consider 26 areas of unmet need, which were explored in 2 face-to-face meetings, in which the statements were debated and amended, resulting in consensus on 30 final statements. The unmet needs identified were categorised into 7 areas: impact of UC on patients' daily life; importance of early diagnosis and treatment; drawbacks of existing treatments; urgent need for new treatments; and disease-, practice- or patient-focused unmet needs.
These expert group meetings found a number of areas of unmet needs in UC, which is an important first step in tackling them in the future. Future research and development should be focused in these areas for the management of patients with UC.
作者旨在进行广泛的文献综述和共识会议，以确定溃疡性结肠炎（UC）中未满足的需求以及克服这些需求的方法。UC是一种复发缓解型炎症性肠病，全球发病率各不相同且不断变化。UC的疾病进程不可预测，且与高昂的健康经济负担相关。在2016年至2017年期间，召集了一个专家小组来识别、讨论和解决UC中未满足需求的领域。
在PubMed和Cochrane图书馆数据库中搜索描述在UC患者中进行的研究的相关文章。这些研究结果被用于生成一组与UC中未满足需求相关的陈述。然后，使用改良的德尔菲评审过程，从9名胃肠病学专家组成的小组中寻求对这些陈述的共识，该过程包括匿名调查和现场会议。
在两项文献综述中，识别出了超过5000条独特记录，共对138篇文章进行了全面评审。这些被用于考虑26个未满足需求的领域，在两次面对面会议中对这些领域进行了探讨，在会议中对陈述进行了辩论和修改，最终就30条最终陈述达成了共识。确定的未满足需求被分为7个领域：UC对患者日常生活的影响；早期诊断和治疗的重要性；现有治疗的缺点；对新治疗的迫切需求；以及以疾病、实践或患者为重点的未满足需求。
这些专家组会议发现了UC中一些未满足需求的领域，这是未来解决这些问题的重要第一步。未来的研发应聚焦于这些领域，以管理UC患者。
