Intest Res.  2016 Jul;14(3):231-239. 10.5217/ir.2016.14.3.231.

Treatment of inflammatory bowel disease in Asia: the results of a multinational web-based survey in the 2nd Asian Organization of Crohn's and Colitis (AOCC) meeting in Seoul

• Nakase H
• Keum B
• Ye BD
• Park SJ
• Koo HS
• Eun CS

• KMID: 2354965
• DOI: http://doi.org/10.5217/ir.2016.14.3.231

Abstract

BACKGROUND/AIMS
Inflammatory bowel disease (IBD) management guidelines have been released from Western countries, but no adequate data on the application of these guidelines in Asian countries and no surveys on the treatment of IBD in real practice exist. Since there is a growing need for a customized consensus for IBD treatment in Asian countries, Asian Organization of Crohn's and Colitis performed a multinational survey of medical doctors who treat IBD patients in Asian countries.
METHODS
A questionnaire was developed between August 2013 and November 2013. It was composed of 4 domains: personal information, IBD diagnosis, IBD treatment, and quality of IBD care. Upon completion of the questionnaire, a web-based survey was conducted between 17 March 2014 and 12 May 2014.
RESULTS
In total, 353 medical doctors treating IBD from ten Asian countries responded to the survey. This survey data suggested a difference in available medical treatments (budesonide, tacrolimus) among Asian countries. Therapeutic strategies regarding refractory IBD (acute severe ulcerative colitis [UC] refractory to intravenous steroids and refractory Crohn's disease [CD]) and active UC were coincident, however, induction therapies for mild to moderate inflammatory small bowel CD are different among Asian countries.
CONCLUSIONS
This survey demonstrated that current therapeutic approaches and clinical management of IBD vary among Asian countries. Based on these results and discussions, we hope that optimal management guidelines for Asian IBD patients will be developed.

Keyword

Asia; Inflammatory bowel diseases; Treatment; A web-survey

MeSH Terms

Asia*
Asian Continental Ancestry Group*
Colitis*
Colitis, Ulcerative
Consensus
Crohn Disease
Diagnosis
Hope
Humans
Inflammatory Bowel Diseases*
Seoul*
Steroids
Steroids

Figure

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  Fig. 1 The treatment employed for mild to moderate extensive UC. 5-ASA, 5-aminosalicylic acid.

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  Fig. 2 The time assessing response to intravenous steroids in acute severe UC.

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  Fig. 3 Second-line therapies in acute severe UC when intravenous steroids fail. TNF, tumor necrosis factor.

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  Fig. 4 Test for cytomegalovirus (CMV) and Clostridium difficile infection in a severe UC attack.

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  Fig. 5 Induction therapy in mild to moderate inflammatory small bowel CD. 5-ASA, 5-aminosalicylic acid.

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  Fig. 6 Combinationtherapy vs. monotherapy for remission induction in thiopurine-naïve inflammatory CD.

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  Fig. 7 Duration of combination therapy with an anti-tumor necrosis factor (TNF) agent and thiopurine for remission induction.

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