For adults with moderately to severely active ulcerative colitis (UC) or Crohn’s disease (CD).
PATIENT PROFILES
Do you see patients like these in your practice?
The Mayo Score is used to assess the severity of ulcerative colitis
The Mayo Score consists of 4 factors1:
- Physician Global Assessment
- Endoscopy findings
- Stool frequency
- Rectal bleeding severity
The Mayo Score ranges from 0-12, with higher scores
indicating more severe disease.
Demonstrating an effect on a composite multiple clinical
factor measure does not represent a clear effect on any of
the individual components.
Bio-naïve moderate ulcerative colitis
Devin, 28
Elementary school teacher
At first, Devin thought his symptoms were caused by nerves from starting out in his career, but they got worse over time. Devin shared with his GI that he likes using steroids because he doesn’t have to take them all the time.
Diagnosis:
Moderate ulcerative colitis
Mayo score 8
7 loose stools daily
Rectal bleeding with some stools
Time Since Diagnosis:
6 months
Imaging:
Colonoscopy showed disease-marked erythema, absent vascular pattern, friability, erosions.
Treatment History:
Devin is currently on steroids. Other
conventional therapies haven’t
provided relief.
Devin says he’s worried about the side effects of biologics. For patients like Devin, assess how informed they are about advanced therapies* and offer to review their safety profiles.
*Advanced therapies are used after failure of conventional therapies.
Bio-naïve severe ulcerative colitis
Corrine, 40
Accountant
Corrine has been living with ulcerative colitis for a long time and has developed coping strategies to work around her symptoms. Now that she’s working from home, running to the bathroom is more convenient than it used to be, but she’s frustrated that the treatments she has tried so far only work for the short term.
Diagnosis:
Severe ulcerative colitis
Mayo score 11
15 loose stools daily
Rectal bleeding with more
than half of stools
Disease Duration:
10 years
Imaging:
Repeat colonoscopy showed
spontaneous bleeding and
ulceration.
Treatment History:
Did not respond well to
immunosuppressants; recently
completed a course of steroids to
manage a flare.
Corrine wonders if infusions or injections would be a better fit for her. For patients like Corrine, consider asking if they’d prefer to self-administer their treatment or have it administered by a healthcare professional.
Consider which treatment you would
recommend for patients like Devin and
Corrine
The Crohn’s Disease Activity Index (CDAI) score is used to assess the severity of Crohn’s disease
The CDAI consists of 8 factors2:
- Number of liquid stools
- Abdominal pain
- General well-being
- Extra-intestinal complications
- Use of anti-diarrheal medications
- Abdominal mass
- Hematocrit levels
- Body weight
CDAI scores range from 0 to ~600, with higher scores
indicating greater severity.3
Demonstrating an effect on a composite multiple clinical
factor measure does not represent a clear effect on any
of the individual components.
Newly diagnosed moderate Crohn’s
Amelia, 26
- Failing conventional therapy
- Eager to reach remission
- Concerned about treatment safety risks
Amelia, a software engineer, started to experience abdominal pain and frequent, loose bowel movements at 26. She tried changing her diet, but her symptoms continued to bother her. Along with regular dialogue with her doctors, she’s been using OTC anti-diarrheal drugs to help manage her day-to-day, and she hopes her abdominal pain will subside.
Patient Background
DISEASE DURATION: 6 months
TYPE: Ileocolitis
TREATMENT HISTORY: Conventional therapy has not provided relief and steroids have only provided partial relief
Current Presentation
MODERATE CROHN’S:
CDAI score 238
- 6 loose stools daily
- Below ideal body weight
- Moderate abdominal pain
- Slightly under par well-being over the past week
- Chronic use of anti-diarrheals
WORKUP: Colonoscopy revealed terminal ileal ulcers with luminal narrowing and stricture of the ileocecal valve, inflammatory ulcers in the transverse colon, and ulcerated lesions in the rectosigmoid colon
FECAL CALPROTECTIN: 650 μg/g
Newly moderate Crohn’s
Elliot, 22
- Steroid-dependent
- Wants to self-administer his maintenance treatment
Elliot has a fast-paced job in a busy restaurant, and he’s worried about missing work. He likes that his treatment has provided him relief, but for the last 3-6 months, he’s struggled to manage his disease. He intermittently sees his GI, but mostly thinks he can continue with his current treatment.
Patient Background
DISEASE DURATION: 1.5 years
TYPE: Ileocolitis
TREATMENT HISTORY: Conventional therapy has provided relief in the past, but he has become dependent on steroids over the last 3-6 months
Current Presentation
MODERATE CROHN’S:
CDAI score 230
- 3 loose stools daily
- Moderate abdominal pain
- Below ideal body weight
- Intermittent OTC anti-diarrheal use
WORKUP: Most recent colonoscopy of terminal ileum shows irregularity and nodularity, along with transverse colonic inflammation
FECAL CALPROTECTIN: 350 μg/g
Consider which treatment you would
recommend for patients like Amelia and Elliot
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Here to support your patients
Once you prescribe ENTYVIO, EntyvioConnect offers a range of
programs designed to help your patients in the way they need it
most.
Learn about starting and maintaining treatment
What do the experts have to
say?
The content on this page has been written and
reviewed by Takeda.
References:
- Schroeder KW, Tremaine WJ, Ilstrup DM. Coated oral 5-aminosalicylic acid therapy for mildly to moderately active ulcerative colitis. A randomized study. N Engl J Med. 1987;317(26):1625-1629.
- Best WR, Becktel JM, Singleton JW, Kern F Jr. Development of a Crohn's disease activity index. National Cooperative Crohn's Disease Study. Gastroenterology. 1976;70(3):439-444.
- Sandborn WJ, Feagan BG, Rutgeerts P, et al; for the GEMINI 2 Study Group. Vedolizumab as induction and maintenance therapy for Crohn’s disease. N Engl J Med. 2013;369(8):711-721.
