Document Detail


Appropriateness of therapy for fistulizing Crohn's disease: findings from a national inflammatory bowel disease cohort.
MedLine Citation:
PMID:  20937046     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
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.
Authors:
V Pittet; P Juillerat; P Michetti; J-P Vader; B Burnand; G Rogler; C Beglinger; F Seibold; C Mottet; C Felley; J-J Gonvers; F Froehlich;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-08-18
Journal Detail:
Title:  Alimentary pharmacology & therapeutics     Volume:  32     ISSN:  1365-2036     ISO Abbreviation:  Aliment. Pharmacol. Ther.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8707234     Medline TA:  Aliment Pharmacol Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  1007-16     Citation Subset:  IM    
Copyright Information:
© 2010 Blackwell Publishing Ltd.
Affiliation:
Institute of Social & Preventive Medicine, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Switzerland. valerie.pittet@chuv.ch
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Investigator
Investigator/Affiliation:
Pierluigi Ballabeni / ; Peter Bauerfeind / ; Christoph Beglinger / ; Stefan Begré / ; José Bengoa / ; Janek Binek / ; Daniel Boller / ; Jan Borovicka / ; Christian Braegger / ; Patrick Brun / ; Bernard Burnand / ; Rafael Camara / ; Dominique Criblez / ; Philippe de Saussure / ; Lukas Degen / ; Joakim Delarive / ; Tobias Ehmann / ; Matthias Engelmann / ; Ali El Wafa / ; Christian Felley / ; Alain Frei / ; Remus Frei / ; Michael Fried / ; Michael Friedt / ; Florian Froehlich / ; Suzanne Gallot-Lavallée / ; Tilman Gerlach / ; Martin Geyer / ; Marc Girardin / ; Oliver Goetze / ; Horst Haack / ; Serge Hediger / ; Peter Hengstler / ; Klaas Heyland / ; Patrick Janiak / ; Pascal Juillerat / ; Vera Kessler Brondolo / ; Christoph Knoblauch / ; Gerd A Kullak-Ublick / ; Michael Manz / ; Rémy Meier / ; Christa Meyenberger / ; Pierre Michetti / ; Christian Mottet / ; Christoph Müller / ; Beat Müllhaupt / ; Thierry Nicolet / ; Andreas Nydegger / ; Isabelle Pache / ; Franziska Piccoli / ; Julia Pilz / ; Valérie Pittet / ; Ronald Rentsch / ; Jean-Pierre Rey / ; Silvia Rihs / ; Daniela Rogler / ; Gerhard Rogler / ; Markus Sagmeister / ; Bernhard Sauter / ; Niklaus Schaub / ; Susanne Schibli / ; Alain Schoepfer / ; Franck Seibold / ; Johannes Spalinger / ; Philippe Stadler / ; Michael Steuerwald / ; Alex Straumann / ; Michael Sulz / ; Michela Tempia-Caliera / ; Joël Thorens / ; John-Paul Vader / ; Stefan Vavricka / ; Jürg Vögtlin / ; Roland Von Känel / ; Gert Wachter / ; Jürg Wermuth / ; Paul Wiesel /

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