Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 30 June 2016

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Test-based strategy vs empiric dose escalation in unresponsive Crohn's disease

A study in the latest issue of Clinical Gastroenterology & Hepatology reports that a test-based strategy is more cost effective than empiric dose escalation for patients with Crohn's disease who lose responsiveness to infliximab.

News image

Patients with Crohn's disease who become unresponsive to therapy with tumor necrosis factor antagonists are managed initially with either empiric dose escalation or testing-based strategies.

The comparative cost effectiveness of these 2 strategies is unknown.

Dr Fernando Velayos from California, USA investigated whether a testing-based strategy is more cost effective than an empiric dose-escalation strategy.

The researchers compared 2 cohorts of patients with Crohn's disease evaluating the outcomes for the 2 strategies over a 1-year time period.

The research team assessed that the incremental cost-effectiveness ratio of the empiric strategy was expressed as cost per quality-adjusted life-year gained, compared with the testing-based strategy.

The team performed a 1-way, probabilistic, and prespecified secondary analyses.

Cost-effectiveness ratio of the empiric strategy ranged to more than $5 million per quality-adjusted life-year gained
Clinical Gastroenterology and Hepatology

The team of doctors reported that the testing strategy yielded similar quality-adjusted life-year compared with the empiric strategy but was less expensive.

In sensitivity analyses, the incremental cost-effectiveness ratio of the empiric strategy ranged from $500,000 to more than $5 million per quality-adjusted life-year gained.

The researchers observed that similar rates of remission and response were achieved through differential use of available interventions.

The testing-based strategy resulted in a higher percentage of surgeries and lower percentage use of high-dose biological therapy.

Dr Velayos's team commented, "A testing-based strategy is a cost-effective alternative to the current strategy of empiric dose escalation for managing patients with Crohn's disease who have lost responsiveness to infliximab."

"The basis for this difference is lower cost at similar outcomes."

Clin Gastroenterol and Hepatol 2013: 11(6): 654-666
28 June 2013

Go to top of page Email this page Email this page to a colleague

 30 June 2016 
Staging system for familial adenomatous polyposis
 30 June 2016 
Antibiotics in children and obesity
 30 June 2016 
IBS-type symptoms in pediatric IBD
 29 June 2016 
Hep C eradication in people who inject drugs
 29 June 2016 
Anti-tumor necrosis factor in mothers and newborns
 29 June 2016 
Progression to esophageal carcinoma in Barrett's
 28 June 2016 
Gastric cancer screening in the USA
 28 June 2016 
Acute severe ulcerative colitis
 28 June 2016 
Cancer recurrence after immune-suppressive therapies
 27 June 2016 
Epidemiology of NAFLD
 27 June 2016 
Tobacco smoking and ulcerative colitis
 27 June 2016 
The Toronto Consensus for H. pylori treatment
 24 June 2016 
Statins and colorectal cancer in IBD
 24 June 2016 
Dietary trends in the USA
 24 June 2016 
Fibre for chronic idiopathic constipation
 23 June 2016 
Biomarker for eosinophilic esophagitis diagnosis
 23 June 2016 
Touch screens in the IBD outpatient clinic
 23 June 2016 
Adverse events after colonoscopy bowel preparations
 22 June 2016 
Benefits and harms of colorectal cancer screening
 22 June 2016 
IBS symptoms in IBD
 22 June 2016 
Outcomes among US veterans with Hep B
 21 June 2016 
Screening for colorectal cancer
 21 June 2016 
Tenofovir and Hep B transmission in mothers
 21 June 2016 
Access to liver subspecialty care and survival
 20 June 2016 
Genes for colorectal cancer risk
 20 June 2016 
Patients and gastroenterologists’ perceptions on IBD
 20 June 2016 
Hep C treatment in people who inject drugs
 17 June 2016 
Noninvasive markers of liver fibrosis
 17 June 2016 
Predictors of starting with long-term PPIs
 17 June 2016 
Extrahepatic manifestations of Hep C
 16 June 2016 
Assessing progression of NAFLD
 16 June 2016 
Endotracheal intubation and endoscopy unit efficiency metrics
 16 June 2016 
Bile acid diarrhea
 15 June 2016 
Consensus for acute severe ulcerative colitis
 15 June 2016 
Dental erosions in GERD
 15 June 2016 
Pharmacological treatments for obesity with weight loss
 14 June 2016 
Antibiotics and gut inflammation
 14 June 2016 
Liver-related mortality in the developed world
 14 June 2016 
Hep C patient outcomes treated with different anti-viral regimens
 13 June 2016 
Obesity in the USA
 13 June 2016 
Celiac disease drug development
 13 June 2016 
Pneumonia risk in celiac disease
 10 June 2016 

Celiac disease drug development

 10 June 2016 
Rectal cancer surgery checklist
 10 June 2016 
Breath as a marker for IBS
 09 June 2016 
Psychological morbidity in young people with IBD
 09 June 2016 
Predicting hepatic encephalopathy in cirrhosis
 09 June 2016 
Evaluation of endoscopic findings from patients with Crohn's
 08 June 2016 
Adult obesity trends in the USA
 08 June 2016 
Pediatric IBD unclassified vs other IBD
 08 June 2016 
Dark chocolate and NASH oxidation
 07 June 2016 
Flexible endoscopy for Zenker's diverticulum
 07 June 2016 
Predicting risk of hepatic encephalopathy in cirrhosis
 07 June 2016 
Electronic learning system for colon capsule endoscopy
 06 June 2016 
Disturbed sleep and symptoms in IBS
 06 June 2016 
Oral contraceptives and Crohn’s complications
 06 June 2016 
Eosinophilic esophagitis
 03 June 2016 
Decision aid for surgical patients with ulcerative colitis
 03 June 2016 
Antibiotic prophylaxis in cirrhosis
 03 June 2016 
Mortality in hospitalized peptic ulcer patients

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2016 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us