Addressing current treatment challenges in Crohn's disease in real life: A physician's survey.

Détails

ID Serval
serval:BIB_EF414EC24545
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Addressing current treatment challenges in Crohn's disease in real life: A physician's survey.
Périodique
Digestive and Liver Disease
Auteur(s)
Vavricka S.R., Radivojevic S., Manser C.N., Frei P., Burri E., Fried M., Schoepfer A., Peyrin-Biroulet L., Michetti P., Rogler G., Biedermann L.
ISSN
1878-3562 (Electronic)
ISSN-L
1590-8658
Statut éditorial
Publié
Date de publication
2014
Peer-reviewed
Oui
Volume
46
Numéro
12
Pages
1066-1071
Langue
anglais
Notes
Publication types: Publication Status: ppublish
Résumé
BACKGROUND: In recent years several trials have addressed treatment challenges in Crohn's disease. Clinical trials however, represent a very special situation.
AIMS: To perform a cross-sectional survey among gastroenterologists on the current clinical real life therapeutic approach focussing on the use of biologics.
METHODS: A survey including six main questions on clinical management of loss of response, diagnostic evaluation prior to major treatment changes, preference for anti-tumour necrosis factor (TNF) agent, (de-)escalation strategies as well as a basic section regarding personal information was sent by mail to all gastroenterologists in Switzerland (n=318).
RESULTS: In total, 120 questionnaires were analysed (response rate 37.7%). 90% of gastroenterologists in Switzerland use a thiopurine as the first step-up strategy (anti-TNF alone 7.5%, combination 2.5%). To address loss of response, most physicians prefer shortening the interval of anti-TNF administration followed by dose increase, switching the biologic and adding a thiopurine. In case of prolonged remission on combination therapy, the thiopurine is stopped first (52.6%) after a mean treatment duration of 15.7 months (biologic first in 41.4%).
CONCLUSIONS: Everyday clinical practice in Crohn's disease patients appears to be incongruent with clinical data derived from major trials. Studies investigating reasons underlying these discrepancies are of need to optimize and harmonize treatment.
Pubmed
Web of science
Création de la notice
18/12/2014 19:29
Dernière modification de la notice
03/03/2018 22:34
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