• James O Lindsay, Nils Picker, Daniel Kromer, Michael Smyth, and Haridarshan Patel.
• Centre for Immunobiology, Blizard Institute, Barts and the London School of Medicine, Queen Mary University of London, London, UK.
• Curr Med Res Opin. 2023 May 1; 39 (5): 681689681-689.

ObjectiveA considerable proportion of patients with moderate-to-severe ulcerative colitis (UC) treated with advanced therapies do not achieve remission, even after 1 year of treatment, and suboptimal response to advanced therapies is frequently observed in clinical practice. This study aimed to analyze clinical practice data in the United Kingdom (UK) and assess the rates of clinical remission and inadequate response with advanced therapies among patients with UC.MethodsThis retrospective chart review included patients with UC who initiated a new advanced therapy (i.e. adalimumab, infliximab, golimumab, tofacitinib, or vedolizumab) between January 2017 and September 2019 from eight clinics across the UK. At least 12 months of data before and after starting an advanced therapy were required. Remission was assessed using components of the Mayo score. Inadequate response was defined by therapeutic adjustment or emergency treatment.ResultsAmong 238 patients included (female: 46.6%; median age: 42.0 years; median follow-up: 28.8 months), 178 patients (74.8%) were biologic-naïve. At 12 months, 87 patients (53.9%) had achieved remission (median time to remission: 7.6 months), although 29 (33.3%) among them had required therapeutic modifications to achieve remission. At 12 months, 105 patients (44.3%) had at least one indicator of an inadequate response (median time to the first indicator of inadequate response: 18.0 months).ConclusionsNearly half of the patients did not achieve remission, and almost half of the included patients had an inadequate response within 1 year after treatment initiation. More effective therapies are needed to effectively treat UC.

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