OBJECTIVES: This study aimed to identify unmet needs for advanced therapies (biologics and Janus kinase inhibitors [JAKi]) in ulcerative colitis (UC).

METHODS: Data were drawn from the Adelphi Disease Specific Programme for UC, a point-in-time survey of gastroenterologists and their 184 consulting patients with UC, collected September 2020-March 2021 in the United Kingdom, capturing gastroenterologist-reported patient demographics, comorbidities, reasons for choice, and areas for improvement of treatment. In total, 117 patients receiving biologics and 67 patients receiving JAKi at the time of consultation were included in the analysis, with comparisons drawn between those 2 groups using the Mann-Whitney U test, t-test, and Fisher exact test.

RESULTS: Patients’ mean age was 38 years (SD 11.5), with mean disease duration 3.5 years (SD 3.2). The most common comorbidities among the overall population were anxiety (9.8%) and depression (6.0%), with no significant difference between the biologics and JAKi patients. Despite therapies being chosen mostly for efficacy (biologics, 100%; JAKi, 94%), efficacy was a key area for improvement (biologics, 58.1%; JAKi, 47.8%), as was safety (biologics, 53.0%; JAKi, 53.7%). Treatment administration/monitoring was a greater unmet need for patients receiving biologics (39.3%) than JAKi (4.5%) (P<0.05), but was less frequently chosen as a reason for switching to the current treatment (biologics, 17.0%; JAKi, 42.2%; P<0.05) than efficacy (biologics, 95.2%; JAKi, 89.1%). Half (49.6%) of the patients receiving biologics were considered candidates for JAKi, but had not received JAKi; the most selected reasons were gastroenterologists preferring to exhaust other treatment options first (36.2%) and concerns about blood clots (24.1%).

CONCLUSIONS: Gastroenterologists considered efficacy and safety as key areas for improvement similarly among biologics and JAKi, demonstrating an existing unmet need for advanced therapies. Treatment administration was a specific unmet need for biologics; despite this, JAKi are likely to be reserved until other treatment options are exhausted.