Understanding Patient and Gastroenterologist Preferences at the Time of Treatment Escalation to First‐Line Advanced Therapy in Ulcerative Colitis: A Discrete Choice Experiment in Five European Countries

Schreiber, S; Walsh, A; Hur, P; Panattoni, L; Hauber, B; Land, N; Coulter, J; Gahlon, G; Wosik, K; Cappelleri, JC; Maravic, MC; Guo, X; Buisson, A

Journal article

Understanding Patient and Gastroenterologist Preferences at the Time of Treatment Escalation to First‐Line Advanced Therapy in Ulcerative Colitis: A Discrete Choice Experiment in Five European Countries

Abstract:: Background: With guidelines recommending earlier advanced therapy (AT) use after 5‐ASA failure for patients with moderately‐to‐severely active ulcerative colitis (UC), it is important to explore treatment preferences at the point of escalation to first‐line AT. Methods: A web‐based discrete choice experiment (DCE) survey was administered to AT‐naïve patients with moderately‐to‐severely active UC and gastroenterologists in 5 European countries. Treatment attributes included time until symptom improvement, probability of remission and corticosteroid‐free remission, risks of cancer, serious infection, and major adverse cardiovascular events (MACE), and mode of administration. Preference weights, relative attribute importance (RAI), and maximum acceptable risk were estimated. A latent class analysis explored preference heterogeneity. Results: Probability of remission at 1 year was the most important attribute for patients (N = 514; RAI = 45.3%) and gastroenterologists (N = 397; RAI = 48.5%). Five‐year cancer risk was the second most important attribute for patients (RAI = 11.8%) and third for gastroenterologists (RAI = 10.9%). RAI of MACE was higher for patients than gastroenterologists (10.6% vs. 6.8%). Both were willing to accept risks for increased probability of remission. Latent class analysis identified 4 groups of patients and 2 groups of gastroenterologists with distinct preferences. The relative importance of efficacy was higher compared with safety in latent classes representing 80% of patients. Conclusion: Clinical remission was most important to patients and gastroenterologists, and both were willing to accept some risk in exchange for the benefits of AT. However, some heterogeneity in preferences was observed. To support patient‐centered, guideline‐concordant care, gastroenterologists should discuss escalation to AT with patients not well‐controlled on conventional therapy, incorporating individual preferences through shared decision‐making.

Publication status:: Published

Peer review status:: Peer reviewed

Actions

Email

Email this record

Send the bibliographic details of this record to your email address.

Your Email
Please enter the email address that the record information will be sent to.

-
Your message (optional)
Please add any additional information to be included within the email.
Share
Cite

Cite this record

APA Style

Schreiber, S., Walsh, A., Hur, P., Panattoni, L., Hauber, B., Land, N., Coulter, J., Gahlon, G., Wosik, K., Cappelleri, J. C., Maravic, M. C., Guo, X., & Buisson, A. (2026). Understanding Patient and Gastroenterologist Preferences at the Time of Treatment Escalation to First‐Line Advanced Therapy in Ulcerative Colitis: A Discrete Choice Experiment in Five European Countries. United European Gastroenterology Journal, 14(5).

MLA Style

Schreiber, S, et al. “Understanding Patient and Gastroenterologist Preferences at the Time of Treatment Escalation to First‐Line Advanced Therapy in Ulcerative Colitis: A Discrete Choice Experiment in Five European Countries.” United European Gastroenterology Journal, vol. 14, no. 5, 2026.

Chicago Style

Schreiber, S, A Walsh, P Hur, et al. 2026. “Understanding Patient and Gastroenterologist Preferences at the Time of Treatment Escalation to First‐Line Advanced Therapy in Ulcerative Colitis: A Discrete Choice Experiment in Five European Countries.” United European Gastroenterology Journal 14 (5).
Print