eHealth: individualisation of infliximab treatment and disease course via a self-managed web-based solution in Crohn’s disease
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eHealth : individualisation of infliximab treatment and disease course via a self-managed web-based solution in Crohn’s disease. / Pedersen, N; Elkjaer, M; Duricova, D; Burisch, J; Dobrzanski, C; Andersen, N N; Jess, T; Bendtsen, F; Langholz, E; Leotta, S; Knudsen, T; Thorsgaard, N; Munkholm, P.
In: Alimentary Pharmacology and Therapeutics, Vol. 36, No. 9, 11.2012, p. 840-9.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - eHealth
T2 - individualisation of infliximab treatment and disease course via a self-managed web-based solution in Crohn’s disease
AU - Pedersen, N
AU - Elkjaer, M
AU - Duricova, D
AU - Burisch, J
AU - Dobrzanski, C
AU - Andersen, N N
AU - Jess, T
AU - Bendtsen, F
AU - Langholz, E
AU - Leotta, S
AU - Knudsen, T
AU - Thorsgaard, N
AU - Munkholm, P
PY - 2012/11
Y1 - 2012/11
N2 - BACKGROUND: Infliximab (IFX) maintenance therapy for Crohn's disease (CD) is administered every 8 weeks, but inter-patient variation in optimal treatment intervals may exist.AIM: To assess, in a prospective pilot study, the efficacy, safety and quality of life (QoL) of IFX maintenance treatment scheduled through web-based self-monitoring of disease activity.METHODS: Twenty-seven CD patients in IFX maintenance therapy were enrolled and received a standardised disease education and web-training. Using the http://www.cd.constant-care.dk concept, patients recorded their disease activity and faecal calprotectin weekly. From this, the inflammatory burden (IB) score was calculated, placing patients in the green, yellow or red zones of a ‘traffic light’ system. If placed in the yellow or red zones, the computer directed these patients to consult their physician for IFX infusion.RESULTS: Seventeen patients (63%) completed 52 weeks of follow-up, 6 (22%) completed 26 weeks and 4 (15%) were excluded due to loss of response, patient decision or non-adherence. In total, 121 IFX infusions were given with a median interval of 9 (range: 4–18) weeks. Only 10% of infusions were given at 8-week intervals, whereas 39% were administered with shorter and 50% with longer intervals respectively. The mean IB and the QoL remained stable during the web-treatment. One mild infusion reaction and one case of folliculitis were observed, while three patients underwent surgery.CONCLUSIONS: The program http://www.cd.constant-care.dk appears to be a practical and safe concept for the individualised scheduling of maintenance treatment with IFX in patients with Crohn's disease. Larger studies are awaited to confirm this preliminary outcome.
AB - BACKGROUND: Infliximab (IFX) maintenance therapy for Crohn's disease (CD) is administered every 8 weeks, but inter-patient variation in optimal treatment intervals may exist.AIM: To assess, in a prospective pilot study, the efficacy, safety and quality of life (QoL) of IFX maintenance treatment scheduled through web-based self-monitoring of disease activity.METHODS: Twenty-seven CD patients in IFX maintenance therapy were enrolled and received a standardised disease education and web-training. Using the http://www.cd.constant-care.dk concept, patients recorded their disease activity and faecal calprotectin weekly. From this, the inflammatory burden (IB) score was calculated, placing patients in the green, yellow or red zones of a ‘traffic light’ system. If placed in the yellow or red zones, the computer directed these patients to consult their physician for IFX infusion.RESULTS: Seventeen patients (63%) completed 52 weeks of follow-up, 6 (22%) completed 26 weeks and 4 (15%) were excluded due to loss of response, patient decision or non-adherence. In total, 121 IFX infusions were given with a median interval of 9 (range: 4–18) weeks. Only 10% of infusions were given at 8-week intervals, whereas 39% were administered with shorter and 50% with longer intervals respectively. The mean IB and the QoL remained stable during the web-treatment. One mild infusion reaction and one case of folliculitis were observed, while three patients underwent surgery.CONCLUSIONS: The program http://www.cd.constant-care.dk appears to be a practical and safe concept for the individualised scheduling of maintenance treatment with IFX in patients with Crohn's disease. Larger studies are awaited to confirm this preliminary outcome.
KW - Adolescent
KW - Adult
KW - Aged
KW - Antibodies, Monoclonal/administration & dosage
KW - Crohn Disease/drug therapy
KW - Denmark
KW - Female
KW - Gastrointestinal Agents/administration & dosage
KW - Health Knowledge, Attitudes, Practice
KW - Humans
KW - Infliximab
KW - Internet
KW - Male
KW - Middle Aged
KW - Patient Education as Topic
KW - Pilot Projects
KW - Prospective Studies
KW - Self Administration/methods
KW - Self Care/methods
KW - Severity of Illness Index
KW - Surveys and Questionnaires
KW - Telemedicine
KW - Treatment Outcome
KW - Young Adult
U2 - 10.1111/apt.12043
DO - 10.1111/apt.12043
M3 - Journal article
C2 - 22971016
VL - 36
SP - 840
EP - 849
JO - Alimentary Pharmacology and Therapeutics, Supplement
JF - Alimentary Pharmacology and Therapeutics, Supplement
SN - 0953-0673
IS - 9
ER -
ID: 219528330