[Argentina and Chile Data Analysis from the ICONIC Observational Study]

The prospective observational ICONIC study assessed, using the Pictorial Representation of Illness and Self Measure (PRISM) tool, the burden of suffering caused to patients by ulcerative colitis (UC).

ICONIC included outpatients with recent-onset UC in 33 countries. Patientand physician-reported outcomes (PRISM, Short Inflammatory Bowel Disease Questionnaire (SIBDQ), Patient Health Questionnaire (PHQ-9), Simple Clinical Colitis Activity Indexes (P-SCCAI; SCCAI)) were collected at baseline and every 6 ± 3 months. Data from Argentina and Chile are described in this analysis.

89 patients (age: median 32, range: 18-63; 52.8% female; left UC: 50%; proctitis: 33.3%; extensive UC: 16.7%) had ≥ 1 follow-up visit. The mean ± SD of severity (SCCAI/pSCCAI) significantly decreased from 1.8 ± 2.2 to 1.4 ± 2.0 (p < 0.05) and from 3.3 ± 3.2 to 2.6 ± 2.8, respectively, over 24 months. Suffering assessed by patients and physicians, progressed to extensive UC. Patient- and physician-rated suffering, as quantified by PRISM, was significantly reduced, showing a correlation with improvement in other outcome measures. An underestimation of physician-assessed suffering by PRISM compared to patient data was described.

The burden and suffering decreased with relatively early treatment. Consistent with the overall study, PRISM was correlated with other measures of UC perception; suffering was underestimated by physicians. PRISM, given its correlation with other scales, it may be considered a useful tool to quantify distress in patients with UC.