Help
Subscribe


All of GastroHep is now free access! - Click here to register Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton 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

 24 April 2014

Advanced search
 24 April 2014 
Imaging liver fat in children
 24 April 2014 
Vitamin D levels in adults with Crohn's disease
 24 April 2014 
Gut microbiota in IBS
 23 April 2014 
Cancer risk after resection of polypoid dysplasia
 23 April 2014 
Fecal microbiota transplantation therapy
 23 April 2014 
Colorectal cancer risk in MUTYH mutation carriers
 22 April 2014 
Endoscopy guidelines to select patients for colonoscopy
 22 April 2014 
PPI use and cancer in Barrett's
 22 April 2014 
Ledipasvir and sofosbuvir for HCV genotype 1
 17 April 2014 
Screening for low bone mineral density among ulcerative colitis
 17 April 2014 
Diabetes mellitus and acute pancreatitis
 17 April 2014 
Bowel cleansing for colonoscopy
 16 April 2014 
Evaluating pharmacologic agents in IBS
 16 April 2014 
Isotretinoin and IBD risk
 16 April 2014 
Mortality in bleeding Mallory-Weiss syndrome vs peptic ulcer bleeding
 15 April 2014 
Dietary fat and risk of IBD
 15 April 2014 
Quality of life in microscopic colitis
 15 April 2014 
New prognostic score for cirrhosis
 14 April 2014 

5-aminosalicylates in early pregnancy and congenital malformation risk

 14 April 2014 
Changing liver cancer mortality rates in the United States
 14 April 2014 
Inflammatory sacroiliitis by MRI in IBD
 11 April 2014 
H pylori resistance to antibiotics
 11 April 2014 
Predictors of corticosteroid treatment outcomes for ulcerative colitis
 11 April 2014 
Antibiotic combination therapy for ulcerative colitis
 10 April 2014 
Mortality in Crohn's disease
 10 April 2014 
Prophylaxis against venous thromboembolism in hospitalized ulcerative colitis
 10 April 2014 
Probiotic treatment and infant colic
 09 April 2014 
Preventing death in general intensive care
 09 April 2014 
Neoplasm risk after polypectomy
 09 April 2014 
Disclosure program and gastroenterology-related claims
 08 April 2014 

Regurgitation and health-related quality of life in GERD

 08 April 2014 
H. pylori resistance to antibiotics
 08 April 2014 
Management of chronic diarrhea
 07 April 2014 
Gastrointestinal angiodysplastic lesions
 07 April 2014 
Meat intake and liver cancer
 07 April 2014 
Adenoma detection and colorectal cancer risk
 04 April 2014 
Stool DNA tests for colorectal cancer
 04 April 2014 
PET-CT predicts outcome in colorectal liver metastases
 04 April 2014 

Prophylaxis of post-ERCP pancreatitis

 03 April 2014 
Management of esophageal or gastric variceal bleeding
 03 April 2014 
Exclusionary diets for IBD
 03 April 2014 
Mortality with chronic pancreatitis
 02 April 2014 
Disease course of early-onset pediatric IBD
 02 April 2014 
Risk of liver fibrosis progression in chronic hep B
 02 April 2014 
Colorectal cancer and patient survival
 01 April 2014 
Outcomes in patients with Hep C
 01 April 2014 
Diagnosis of functional dyspepsia
 01 April 2014 
Genetic risk factors for stenosis and infections in primary sclerosing cholangitis
 31 March 2014 
Diet-gene interactions and Crohn's
 31 March 2014 
Transjugular intrahepatic portosystemic stent-shunts in Budd–Chiari syndrome
 31 March 2014 
Hepatic decompensation in antiretroviral-treated patients
 28 March 2014 
Glucocorticoids and mortality after colorectal cancer surgery
 28 March 2014 
Long-term metformin use and gastric cancer risk
 28 March 2014 
Distance from a liver transplant center and survival
 27 March 2014 
Radiofrequency ablation vs endoscopy for Barrett's
 27 March 2014 
Omega-3 fatty acid and Crohn's disease
 27 March 2014 
Thromboembolism prophylaxis in IBD
 26 March 2014 
Disparities in evaluation of rectal bleeding
 26 March 2014 
Prediction of H. pylori status after endoscopy
 26 March 2014 
Fatigue and depression in IBD

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2014 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us