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Safety and cost of infliximab for the treatment of Belgian pediatric patients with Crohn’s disease

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Abstract
Biologicals have become an important component in the treatment of Crohn’s disease in children. Their increased and long term use raises safety concerns. We describe safety and cost of infliximab in Belgian pediatric Crohn’s disease patients. All patients on infliximab as part of the present or past treatment for Crohn’s Disease until January 1st 2011 were selected from an existing database. Information on disease phenotype, medication and adverse events were extracted. Adverse events occurred in 25.9% of patients exposed to infliximab of which 29.6% were severe. In total 31.7% of patients stopped infliximab therapy. The main reasons for discontinuation were adverse events in 45.4% and loss of response in 30.3%. No malignancies or lethal complications occurred over this 241 patient year observation period. Immuno-modulators were concomitant medication in 75% of patients and were discontinued subsequently in 38.4% of them. The cost of infliximab infusions per treated patient per year in the Belgian health care setting is approximately 9 474 euro, including only medication and hospital related costs. Even though infliximab is relatively safe in pediatric CD on the short term, close follow-up and an increased awareness of the possible adverse reactions is highly recommended. Adverse reactions appeared in 25.9% of all patients and were the main reason for discontinuation. Treatment cost has to be balanced against efficacy and modifications in disease course. In the Belgian health care system, the medication is available to all patients with moderate to severe CD.
Keywords
Crohn’s disease, pediatric, biological treatment, cost., safety

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Chicago
De Greef, E, I Hoffman, G D’Haens, Stephanie Van Biervliet, F Smets, M Scaillon, O Dewit, et al. 2012. “Safety and Cost of Infliximab for the Treatment of Belgian Pediatric Patients with Crohn’s Disease.” Acta Gastro-enterologica Belgica 75 (4): 425–431.
APA
De Greef, E, Hoffman, I., D’Haens, G., Van Biervliet, S., Smets, F., Scaillon, M., Dewit, O., et al. (2012). Safety and cost of infliximab for the treatment of Belgian pediatric patients with Crohn’s disease. ACTA GASTRO-ENTEROLOGICA BELGICA, 75(4), 425–431.
Vancouver
1.
De Greef E, Hoffman I, D’Haens G, Van Biervliet S, Smets F, Scaillon M, et al. Safety and cost of infliximab for the treatment of Belgian pediatric patients with Crohn’s disease. ACTA GASTRO-ENTEROLOGICA BELGICA. 2012;75(4):425–31.
MLA
De Greef, E, I Hoffman, G D’Haens, et al. “Safety and Cost of Infliximab for the Treatment of Belgian Pediatric Patients with Crohn’s Disease.” ACTA GASTRO-ENTEROLOGICA BELGICA 75.4 (2012): 425–431. Print.
@article{3128726,
  abstract     = {Biologicals have become an important component in the treatment of Crohn{\textquoteright}s disease in children. Their increased and long term use raises safety concerns. We describe safety and cost of infliximab in Belgian pediatric Crohn{\textquoteright}s disease patients. All patients on infliximab as part of the present or past treatment for Crohn{\textquoteright}s Disease until January 1st 2011 were selected from an existing database. Information on disease phenotype, medication and adverse events were extracted. Adverse events occurred in 25.9\% of patients exposed to infliximab of which 29.6\% were severe. In total 31.7\% of patients stopped infliximab therapy. The main reasons for discontinuation were adverse events in 45.4\% and loss of response in 30.3\%. No malignancies or lethal complications occurred over this 241 patient year observation period. Immuno-modulators were concomitant medication in 75\% of patients and were discontinued subsequently in 38.4\% of them. The cost of infliximab infusions per treated patient per year in the Belgian health care setting is approximately 9 474 euro, including only medication and hospital related costs. Even though infliximab is relatively safe in pediatric CD on the short term, close follow-up and an increased awareness of the possible adverse reactions is highly recommended. Adverse reactions appeared in 25.9\% of all patients and were the main reason for discontinuation. Treatment cost has to be balanced against efficacy and modifications in disease course. In the Belgian health care system, the medication is available to all patients with moderate to severe CD.},
  author       = {De Greef, E and Hoffman, I and D{\textquoteright}Haens, G and Van Biervliet, Stephanie and Smets, F and Scaillon, M and Dewit, O and Peeters, Harald and Paquot, I and Alliet, P and Arts, W and Hauser, B and Vermeire, S and Van Gossum, A and Rahier, JF and Etienne, I and Louis, E and Coche, JC and Mahachie John, J and Van Steen, Kristel and Veereman, G},
  issn         = {0001-5644},
  journal      = {ACTA GASTRO-ENTEROLOGICA BELGICA},
  keyword      = {Crohn{\textquoteright}s disease,pediatric,biological treatment,cost.,safety},
  language     = {eng},
  number       = {4},
  pages        = {425--431},
  title        = {Safety and cost of infliximab for the treatment of Belgian pediatric patients with Crohn{\textquoteright}s disease},
  volume       = {75},
  year         = {2012},
}

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