Background and importance Biological treatments have improved the therapeutic options for inflammatory bowel disease (IBD) and have shown high clinical efficacy. Nevertheless, some patients do not respond to initial treatment or present loss of response over time. To prevent the loss of efficacy, treatment intensification has been employed, usually applied empirically based on the clinical condition of the patient and biochemical parameters. The introduction of tumour necrosis factor antagonist (anti-TNF) monitoring in clinical practice allows a more accurate selection of strategies.
Aim and objectives To analyse the number of patients receiving treatment with a biological agent for IBD and requiring an intensification regimen, including increasing dosage or shortening the administration interval, and to evaluate the economic impact of this intensification strategy.
Material and methods This was a retrospective observational study in patients diagnosed with IBD and under an intensified regimen of a biological agent. The cost per patient was estimated based on the extrapolation of the price of each medication for 1 year of treatment. In addition, the difference in costs per patient and year for each treatment and the total economic impact were calculated.
Results A total of 549 patients with IBD were receiving a biological treatment and 239 required an intensification regimen (table 1).
Conclusion and relevance Intensification regimens, including increasing dosage or shortening the administration intervals, were frequent in our hospital, both for anti-TNF and for other biological agents used for the treatment of IBD. These strategies involve an important economic impact, as well as a high risk of infection for patients. Intensification should be guided by pharmacokinetic monitoring. More studies are needed to validate therapeutic algorithms that allow optimisation of resources for all biological agents used.
References and/or acknowledgements No conflict of interest.
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