Survey reveals important differences in how patients and physicians define disease remission and the importance of remission as a clinical goal1
The high prevalence of corticosteroid therapy currently in use in IBD management reflects a significant unmet need for better therapies2
Findings suggest greater need for alignment between patients and physicians on treatment goals and measures of success as well as new treatment options that provide sustained disease control beyond what is achieved with current therapies1,2
Bristol-Myers Squibb Company (NYSE:BMY) today announced the results of a robust multinational inflammatory bowel disease (IBD) survey conducted among patients and physicians, with findings revealing urgent and unmet needs in several key areas, including differences in expectations between patients and physicians that may impact disease management and treatment decisions.1,2 The IBD Global Assessment of Patient and Physician Unmet Needs Survey (IBD GAPPS) captured insights and perspectives from more than 2,000 patients and 600 physicians, exploring the physician-patient relationship, how patients and physicians define remission, their treatment expectations and levels of satisfaction with current therapies, as well as the impact of ulcerative colitis (UC) and Crohn’s disease (CD) on disease-related quality of life.1,2 Results from the survey were presented at the 15th Congress of the European Crohn's and Colitis Organisation (ECCO) in Vienna, Austria.
"As gastroenterologists and patients work together to best manage IBD, we need to shift the conversation from focusing on short-term goals like symptom relief to an emphasis on achieving long-term disease control so that patients can lead productive lives," said David T. Rubin, M.D., Section Chief of Gastroenterology, Hepatology and Nutrition, Co-Director, Digestive Diseases Center, University of Chicago Medicine and Chair of the IBD GAPPS Steering Committee. "IBD GAPPS provides real-world insight into fundamental gaps in understanding, communication and expectations between patients and physicians that are important to consider in our approach to setting treatment goals and improving long-term disease outcomes."
IBD GAPPS, an Institutional Review Board (IRB)-approved survey, was developed based on insights from a multinational steering committee, input from patient and professional advocacy groups and patient feedback.1 The online survey was conducted from August to November 2019 in the United States, Canada, France, Germany, Italy, Spain and the United Kingdom.1 It involved 2,398 patients aged 18 years or older diagnosed with ulcerative colitis or Crohn’s disease who had taken prescription medication for their condition.1 Additionally, surveys were completed by 654 gastroenterologists responsible for their patients’ treatment decisions who had an average monthly caseload of 268 patients, including approximately 43 ulcerative colitis and 43 Crohn’s disease patients.1
"The IBD GAPPS findings illuminate emerging and underrecognized needs that exist for patients and physicians," said Michael Osso, President and CEO, Crohn's & Colitis Foundation. "Our hope is that these results create dialogue and urgency within the IBD community to advance solutions that lead to better communication between patients and providers, improved long-term disease control and the best possible care for patients."
Important Differences Exist Between How Patients and Physicians Define Remission1
The survey revealed important and meaningful differences in how patients and physicians define IBD remission.1 The majority of physicians defined remission based on clinical test results (64 percent of physicians for CD, 70 percent for UC) whereas patients (45 percent) most commonly defined remission as the resolution of IBD symptoms.1 Additionally, while most physicians and patients acknowledge discussing remission (93 percent of physicians, 78 percent of patients), their distinct definitions of remission highlight a need for greater alignment.1
High Prevalence of Corticosteroid Use Reflects Significant Unmet Need for Improved Therapies2
Results from IBD GAPPS showed that more than one-third of IBD patients (35 percent of CD patients, 39 percent of UC patients) used corticosteroids for four or more months over the past year to control their disease.2 Physicians believe more than 40 percent of IBD patients will require four or more months of corticosteroid use per year to maintain disease control.2 Yet despite high patient concern over any corticosteroid use, and most patients wanting to stop corticosteroid treatment as soon as their disease is under control, only approximately 50 percent of physicians expressed concern over four or more months of corticosteroid use per year.2
Physicians’ Satisfaction with Remission Rates & Sustained Treatment Response May Impact Treatment Outcomes1
Based on the survey findings, physicians’ satisfaction with relatively low IBD remission and durability rates may suggest an acceptance of sub-optimal outcomes in chronic disease control.1 Physicians indicated up to 63 percent of IBD patients will not obtain remission with current therapies; however, many physicians are highly satisfied with these results (25 percent of physicians for CD, 36 percent for UC).1 Additionally, physicians (up to 58 percent for UC and up to 63 percent for CD) reported that they see an average sustained response of at least one or at least two years with current therapies, with most physicians moderately to highly satisfied with these results.1
Despite these low physician expectations, most patients believe remission is a feasible treatment goal, and approximately one-third of patients expect their treatment to provide five or more years of disease control.1 These expectations exist despite many patients (61 percent) reporting only partial IBD control with current therapies.1
"The IBD GAPPS data presented at ECCO underscore BMS’s commitment to partnering with the IBD community to highlight urgent and significant unmet needs impacting care for patients," said Mary Beth Harler, M.D., Head of Immunology and Fibrosis Development, Bristol-Myers Squibb. "We recognize the debilitating impact that ulcerative colitis and Crohn’s disease can have on the lives of patients, and together with the community, are focused on solutions that transform outcomes for all those impacted by these diseases."
Bristol-Myers Squibb plans to submit the survey findings for publication in a peer-reviewed journal and present additional findings at future scientific congresses.
About IBD GAPPS1
The IBD Global Assessment of Patient and Physician Unmet Needs Survey (IBD GAPPS) evaluated how moderate to severe ulcerative colitis (UC) and moderate to severe Crohn’s disease (CD) impacted the lives of patients.1 IBD GAPPS, which was approved by an Institutional Review Board (IRB), was developed based on insights from a multinational gastroenterologist steering committee, input from patient and professional advocacy groups and patient feedback. This internet-based survey was conducted across the United States, Canada, France, Germany, Italy, Spain and the United Kingdom.1 It involved 2,398 patients aged 18 years or older who had taken a prescription medication for their disease. Of the patients taking the survey, 78 percent of UC patients and 93 percent of CD patients had moderate to severe disease.1 Additionally, surveys were completed by 654 gastroenterologists responsible for their patients’ treatment decisions who had an average monthly caseload of 268 patients, including approximately 43 ulcerative colitis and 43 Crohn’s disease patients.1 Approximately 62 percent and 67 percent of their UC and CD patients, respectively, were classified as moderate to severe.1
About Bristol-Myers Squibb
Bristol-Myers Squibb is a global biopharmaceutical company whose mission is to discover, develop and deliver innovative medicines that help patients prevail over serious diseases. For more information about Bristol-Myers Squibb, visit us at BMS.com or follow us on LinkedIn, Twitter, YouTube, Facebook and Instagram.
Celgene and Juno Therapeutics are wholly owned subsidiaries of Bristol-Myers Squibb Company. In certain countries outside the U.S., due to local laws, Celgene and Juno Therapeutics are referred to as, Celgene, a Bristol-Myers Squibb company and Juno Therapeutics, a Bristol-Myers Squibb company.
- Afzali A, et al. Patient and physician perspectives on the management of Inflammatory Bowel Disease: Disease remission and durability of treatment. Poster 482. Presented at 15th Congress of ECCO 2020.
- Afzali A, et al. Patient and physician perspectives on the management of Inflammatory Bowel Disease: Role of steroids in the context of biologic therapy. Poster 393. Presented at 15th Congress of ECCO 2020.