iSTART (i Support Therapy-Access to Rapid Treatment) is a Ferring Pharmaceuticals initiative consisting of a global expert panel to improve patient-centred management for mild to moderate UC. Under iSTART, patients on optimised first-line therapy will be provided with training on how to identify a flare and provided with a prescription to self-start a time limited, second-line treatment (Cortiment®) for use when their first-line 5-ASA treatment is no longer maintaining remission.
Only select patients should be chosen by physicians for this initiative. These are those patients who:

• Are at high risk of relapse
• Have limited access to healthcare services
• Have an active interest in their disease
• Have a low risk of clostridium difficile infection

iSTART aims to provide patients with the ability to:

• Self-assess symptoms
• Increase dosing of first-line therapy
• Self-start a short course of second-line treatment

It is designed to fit within the framework supplied by published treatment guidelines.

For an initiative like iSTART to work, patients require reliable methods to self-assess their condition. Appropriate indices (as they are simple and validated) include:

• PRO2 which uses stool frequency and rectal bleeding as indicators
• PRUCSI which uses the 6-point Mayo score and general well-being
• mHI-UC which incorporates patient-reported measures derived from the UCDAI

^{PRO2 = Patient reported outcome; PRUCSI = Patient-reported UC activity index; mHI-UC = mobile health index for UC.}