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Appropriateness of therapy for fistulizing Crohn’s disease: findings from a national inflammatory bowel disease cohort

Pittet, V. ; Juillerat, P. ; Michetti, P. ; Vader, J.‐P. ; Burnand, B. ; Rogler, G. ; Beglinger, C. ; Seibold, F. ; Mottet, C. ; Felley, C. ; Gonvers, J.‐J. ; Froehlich, F.

Alimentary pharmacology & therapeutics, 2010-10, Vol.32 (8), p.1007-1016 [Peer Reviewed Journal]

Oxford, UK: Blackwell Publishing Ltd

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Title:
Appropriateness of therapy for fistulizing Crohn’s disease: findings from a national inflammatory bowel disease cohort
Author: Pittet, V. ; Juillerat, P. ; Michetti, P. ; Vader, J.‐P. ; Burnand, B. ; Rogler, G. ; Beglinger, C. ; Seibold, F. ; Mottet, C. ; Felley, C. ; Gonvers, J.‐J. ; Froehlich, F.
Subjects: Adult ; Antibodies, Monoclonal - therapeutic use ; Biological and medical sciences ; Cohort Studies ; Crohn Disease - complications ; Crohn Disease - drug therapy ; Crohn Disease - surgery ; Crohn Disease - therapy ; Cross-Sectional Studies ; Digestive system ; Female ; Fistula - therapy ; Gastroenterology. Liver. Pancreas. Abdomen ; Gastrointestinal Agents - therapeutic use ; Humans ; Immunosuppressive Agents - therapeutic use ; Male ; Medical sciences ; Middle Aged ; Other diseases. Semiology ; Pharmacology. Drug treatments ; Quality Assurance, Health Care - methods ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus ; Tumor Necrosis Factor-alpha - therapeutic use ; Young Adult
Is Part Of: Alimentary pharmacology & therapeutics, 2010-10, Vol.32 (8), p.1007-1016
Notes: See Appendix.
ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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Description: Aliment Pharmacol Ther 2010; 32: 1007–1016 Summary Background About 30–50% of patients with Crohn’s disease (CD) develop fistulae, implying significant disease burden and complicated clinical management. Aim To assess appropriate use of therapy for fistulizing CD patients enrolled in the Swiss Inflammatory Bowel Disease Cohort using criteria developed by the European Panel on the Appropriateness of Crohn’s disease Therapy. Methods Specific questionnaires were used to gather information on disease and its management. We assessed appropriateness of therapy at enrolment for adult CD patients with one or several fistulae. Results Two hundred and eighty‐eight CD patients had fistulizing disease, of which 80% had complex fistulae and 32% currently had active draining fistulae. Mean age (s.d.) at diagnosis was 27 years (11), 51% males. Of the patients, 78% were judged as having globally an appropriate therapy, which was more often given for complex fistulae (87%) than for simple fistulae (67%). Antibiotics, azathioprine/MP, methotrexate and conservative surgery were almost always appropriate. Anti‐tumor necrosis factor α was considered globally appropriate (91%), although most often with an uncertain indication. The 5ASA compounds, steroids and aggressive surgery were most often inappropriate (84%, 58% and 86% respectively). Conclusions Formal appropriateness criteria for CD therapy were applied to a national cohort of IBD patients. For more than three‐quarters of the patients with fistulizing CD, therapy was globally appropriate.
Publisher: Oxford, UK: Blackwell Publishing Ltd
Language: English

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Appropriateness of therapy for fistulizing Crohn’s disease: findings from a national inflammatory bowel disease cohort

Pittet, V. ; Juillerat, P. ; Michetti, P. ; Vader, J.‐P. ; Burnand, B. ; Rogler, G. ; Beglinger, C. ; Seibold, F. ; Mottet, C. ; Felley, C. ; Gonvers, J.‐J. ; Froehlich, F.

Oxford, UK: Blackwell Publishing Ltd

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