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The aim of this study was to describe the pre-biologic treatment and health care experience, including co-morbidities and overall health care utilization, for UC patients who initiated biologic therapies, in the 5\u00a0years prior to the initiation of the first biologic agent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>UC patients who initiated a biologic agent approved for UC between 9\/15\/2005 and 1\/30\/2018 were identified from the IBM\u00ae MarketScan\u00ae Commercial Database, a large US database. The date of the first recorded UC biologic exposure was defined as the index date, and\u2009\u2265\u20095\u00a0years of pre-index records were required to evaluate patients\u2019 treatment, disease progression and overall health care utilization prior to initiating biologic agents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 1891 eligible patients, treatment with oral corticosteroids, 5-aminosalicylates, and other non-biologic immunomodulators, all increased progressively across the 5\u00a0years prior to the index. From within year-five to within year-one prior to the index, the median duration of oral corticosteroid treatment increased from 34 to 88\u00a0days per year and the proportion of patients who experienced more extensive\/pancolitis disease increased from 16 to 59%. Overall, the frequency of all-cause health care visits also increased.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with UC experienced increasing morbidity and treatment burden in the 5\u00a0years prior to initiating biologic therapy. To achieve reduced corticosteroids in UC management, better risk stratification is needed to help identify patients for more timely biologic treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12876-021-01708-6","type":"journal-article","created":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T05:06:25Z","timestamp":1615957585000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Understanding patient journey in ulcerative colitis prior to biologic initiation: a 5-year exploration"],"prefix":"10.1186","volume":"21","author":[{"given":"Yiting","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rupa","family":"Makadia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Knoll","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jill","family":"Hardin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erica A.","family":"Voss","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Fife","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kourtney","family":"Davis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheldon","family":"Sloan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,3,17]]},"reference":[{"issue":"4","key":"1708_CR1","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1038\/ajg.2018.27","volume":"113","author":"GR Lichtenstein","year":"2018","unstructured":"Lichtenstein GR, Loftus EV, Isaacs KL, et al. 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Data were de-identified and comply with the Health Insurance Portability and Accountability Act and the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The use of the IBM\u00ae Marketscan\u00ae databases was reviewed by the New England Institution Review Board (IRB) and was determined to be exempt from broad IRB approval, as this research project did not involve human subject research. Informed consent was not obtained as this research project did not involve human subject research.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"YW, RM, CK, JH, EV, DF, KD, are full-time employees of Janssen R&D, LLC, a unit of Johnson & Johnson. At the time of this work, SS was employed by Janssen Global Services, LLC, a unit of Johnson & Johnson. The work on this study was part of their employment. They also hold pension rights from the company and own stock and stock options.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"121"}}