Yanai Shunichi, Toya Yosuke, Nakamura Shotaro, Matsumoto Takayuki
Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Iwate, Japan.
Crohns Colitis 360. 2020 Apr 17;2(2):otaa030. doi: 10.1093/crocol/otaa030. eCollection 2020 Apr.
The therapeutic drugs available for ulcerative colitis (UC) have recently increased. However, use of topical therapy for UC in Japan has not been determined. This study aimed to investigate real-world use of topical therapy for UC in Japan using a web-based survey designed for UC patients.
A web-based questionnaire on UC management was administered to 773 patients over a 2-day period in September 2019. The responses regarding topical therapy use were analyzed.
Questionnaire responses were obtained from 323 UC patients. Of these, the mean disease duration was 12.2 years, and 220 patients (68.1%) had used topical therapy, of whom 68 (21.1%) were currently using this treatment. The frequency of using the prescribed topical therapy was appropriate in 36.8% of patients, only when needed in 38.6%, and rarely in 24.5%. Among all topical therapy users, 64.4% reported that budesonide foam was easy to use, which was significantly higher than the rates for mesalazine suppositories (43.6%), mesalazine enemas (12.9%), and glucocorticoid enemas (13.9%; < 0.05). Regarding treatment effects, 68.9% of patients were satisfied with the budesonide foam, which was a significantly higher rate of satisfaction than those for mesalazine suppositories (44.6%), mesalazine enemas (30.2%), glucocorticoid enemas (36.1%), and glucocorticoid suppositories (41.9%; < 0.05).
Although topical therapy use was common in this Japanese UC population, patient adherence was not very high. Of all the topical therapy types, budesonide foam, which has recently become available, was rated highly by these patients.
目前可用于治疗溃疡性结肠炎（UC）的药物有所增加。然而，日本对于UC局部治疗的应用情况尚未明确。本研究旨在通过一项针对UC患者设计的网络调查，探究日本UC局部治疗的实际应用情况。
2019年9月，在两天时间内，向773例患者发放了一份关于UC管理的网络调查问卷。对有关局部治疗使用情况的回答进行了分析。
共获得323例UC患者的问卷回复。其中，平均病程为12.2年，220例患者（68.1%）曾使用过局部治疗，其中68例（21.1%）目前仍在使用该治疗方法。36.8%的患者按规定频率使用局部治疗，38.6%的患者仅在需要时使用，24.5%的患者很少使用。在所有局部治疗使用者中，64.4%的患者表示布地奈德泡沫剂易于使用，这一比例显著高于美沙拉嗪栓剂（43.6%）、美沙拉嗪灌肠剂（12.9%）和糖皮质激素灌肠剂（13.9%；P<0.05）。关于治疗效果，68.9%的患者对布地奈德泡沫剂满意，这一满意度显著高于美沙拉嗪栓剂（44.6%）、美沙拉嗪灌肠剂（30.2%）、糖皮质激素灌肠剂（36.1%）和糖皮质激素栓剂（41.9%；P<0.05）。
尽管局部治疗在日本的UC患者中应用普遍，但患者的依从性并不高。在所有局部治疗类型中，最近才可用的布地奈德泡沫剂得到了这些患者的高度评价。
