B0369 - An Insight into the Patient’s Perspective of Ulcerative Colitis Flares via Analysis of Online Public Forum Posts: Key Triggers and Symptoms of Flares

David T. Rubin, MD, FACG¹, Joana Torres, MD, PhD², Iris Dotan, MD³, Lan Terry Xu, ⁴, Irene Modesto, MD⁵, John C. Woolcott, PhD⁶, Sean Gardiner, MD⁵, Bruce E. Sands, MD, MS, FACG^7
1University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL; ²Hospital Beatriz Ângelo, Loures, Portugal and Hospital da Luz, Lisbon, Lisboa, Portugal; ³Rabin Medical Center, Petah Tikva, Israel and Tel Aviv University, Ramat Aviv, Tel Aviv, Israel; ⁴Netbase Quid, Santa Clara, CA; ⁵Pfizer Inc, New York, NY; ⁶Pfizer Inc, Collegeville, PA; ⁷Icahn School of Medicine at Mount Sinai, New York, NY

Introduction: Prediction of flares in UC remains a challenge, with limited analyses on patient (pt)-reported themes associated with onset. The aim of this analysis was to identify the most common pt-reported triggers and symptoms of UC flares.

Methods: We reviewed online posts written by pts with UC on 8 public forums in 6 countries between January 1, 2019 and February 14, 2021. Flare-related posts (identified by keywords; Table), including pre- and post-flare posts from the same pts, were captured using Netbase Quid™ artificial intelligence text analytics and natural language processing software. Once identified, all flare-related posts were analyzed and mapped semantically to uncover the most prevalent conversational topics and themes regarding flares to outline the unmet needs and challenges discussed and to examine self-reported triggers of flares.

Results: Of > 27,000 pt posts, 12,900 were identified as flare-related. The most common themes identified were treatment experiences, side-effects (28%), and flare symptoms (22%; Figure a). Of the top topics discussed, the most common was emotional / peer support (9.4% of posts), followed by posts on the individual experiences and recommendations of mesalamine (and other oral / rectal suppositories; 8.0% of posts), the most common treatment option discussed, and dietary recommendations (6.0% of posts; Figure b). Pain was a high‑impact topic (fatigue and joint pain, 2.4% of posts; Figure b). Stress and anxiety were the most reported triggers of flares (38% of posts), followed by diet (28% of posts; Table), with discussions suggesting pts with UC had difficulty managing external stressors. Depression, anxiety, and fatigue were frequently identified as both triggers for and symptoms of flares. Initial symptoms of flares (e.g., blood in stool; diarrhea and loose stool; stool frequency) were often not distinguished from full flares. Blood in the stool was the most discussed flare indicator (58%; Table).

Discussion: The results of this analysis of pt posts suggest that some frequently discussed triggers and / or symptoms of UC flares, such as depression, anxiety, pain, and sleep disturbances, are not always captured using traditional clinical disease activity measures.^1,2 Physicians should consider additional pt-reported outcomes, including emotional and psychological aspects, during the assessment of pts.

References

1. Sturm A et al. J Crohns Colitis 2019;13(3):273-284
2. Rubin DT et al. Am J Gastroenterol 2019;114(3):384-413





Disclosures:


David T. Rubin, MD, FACG¹, Joana Torres, MD, PhD², Iris Dotan, MD³, Lan Terry Xu, ⁴, Irene Modesto, MD⁵, John C. Woolcott, PhD⁶, Sean Gardiner, MD⁵, Bruce E. Sands, MD, MS, FACG⁷. B0369 - An Insight into the Patient’s Perspective of Ulcerative Colitis Flares via Analysis of Online Public Forum Posts: Key Triggers and Symptoms of Flares, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.