{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T17:12:59Z","timestamp":1788369179545,"version":"build-2803163510"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,6,28]],"date-time":"2024-06-28T00:00:00Z","timestamp":1719532800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Ulcerative proctitis (UP) can have a milder, less aggressive course than left\u2010sided colitis or extensive colitis. Therefore, immunosuppressants tend to be used less in patients with this condition. Evidence, however, is scarce because these patients are excluded from randomised controlled clinical trials. Our aim was to describe the characteristics of patients with refractory UP and their disease\u2010related complications, and to identify the need for immunosuppressive therapies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We identified patients with UP from the prospective ENEIDA registry sponsored by the GETECCU. We evaluated socio\u2010demographic data and complications associated with immunosuppression. We defined immunosuppression as the use of immunomodulators, biologics and\/or small molecules. We used logistic regression to identify factors associated with immunosuppressive therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From a total of 34,716 patients with ulcerative colitis, we identified 6281 (18.1%) with UP; mean\u2009\u00b1\u2009SD age 53\u2009\u00b1\u200915\u2009years, average disease duration of 12\u2009\u00b1\u20099\u2009years. Immunosuppression was prescribed in 11% of patients, 4.2% needed one biologic agent and 1% needed two; 2% of patients required hospitalisation, and 0.5% underwent panproctocolectomy or subtotal colectomy. We identified 0.2% colorectal tumours and 5% extracolonic tumours. Patients with polyarthritis (OR 3.56, 95% CI 1.86\u20136.69; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) required immunosuppressants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Among patients with refractory UP, 11% required immunosuppressant therapy, and 4.2% required at least one biologic agent.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.18133","type":"journal-article","created":{"date-parts":[[2024,6,29]],"date-time":"2024-06-29T04:34:22Z","timestamp":1719635662000},"page":"604-612","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Need for therapeutic escalation in patients with refractory ulcerative proctitis: Results from the <scp>PROCU<\/scp> study of the <scp>ENEIDA<\/scp> registry"],"prefix":"10.1111","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0469-4332","authenticated-orcid":false,"given":"Roc\u00edo","family":"Ferreiro\u2010Iglesias","sequence":"first","affiliation":[{"name":"Fundaci\u00f3n Instituto de Investigaci\u00f3n Sanitaria de Santiago de Compostela (FIDIS) Hospital Cl\u00ednico Universitario de Santiago  Santiago de Compostela Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sol","family":"Porto\u00a0Silva","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n Instituto de Investigaci\u00f3n Sanitaria de Santiago de Compostela (FIDIS) Hospital Cl\u00ednico Universitario de Santiago  Santiago de Compostela Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Mar\u00edn","sequence":"additional","affiliation":[{"name":"UCO, IMIBIC Hospital Universitario Reina Sof\u00eda  C\u00f3rdoba Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8233-9638","authenticated-orcid":false,"given":"Mar\u00eda Jos\u00e9","family":"Casanova","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd), Hospital Universitario de La Princesa, Instituto de Investigaci\u00f3n Sanitaria Princesa (IIS\u2010Princesa) Universidad Aut\u00f3noma de Madrid (UAM)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9051-2581","authenticated-orcid":false,"given":"M\u00edriam","family":"Ma\u00f1osa","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd) Hospital Universitari Germans Trias i Pujol, Badalona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Gonz\u00e1lez\u2010Mu\u00f1oza","sequence":"additional","affiliation":[{"name":"Hospital Santa Creu i Sant Pau, Institut d'Investigacions Biom\u00e8diques (IIB) Sant Pau  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"de Francisco","sequence":"additional","affiliation":[{"name":"Hospital Universitario Central de Asturias, and Instituto de Investigaci\u00f3n Sanitaria del Principado de Asturias (ISPA)  Oviedo Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berta","family":"Caballol","sequence":"additional","affiliation":[{"name":"CIBERehd. 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