The Continental Divide: Anti-TNF Use in Pediatric IBD Is Different in North America Compared to Other Parts of the World
Background and Aims. Use of anti-TNF therapies varies internationally. As an initiative of the international Pediatric IBD Network (PIBDNet), we compared global pediatric IBD anti-TNF practice patterns. Methods. Physicians were surveyed about anti-TNF use in Crohn’s disease (CD) and ulcerative colit...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Canadian Journal of Gastroenterology and Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2018/3190548 |
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| author | Peter C. Church Jeffrey Hyams Frank Ruemmele Lissy de Ridder Dan Turner Anne M. Griffiths |
| author_facet | Peter C. Church Jeffrey Hyams Frank Ruemmele Lissy de Ridder Dan Turner Anne M. Griffiths |
| author_sort | Peter C. Church |
| collection | DOAJ |
| description | Background and Aims. Use of anti-TNF therapies varies internationally. As an initiative of the international Pediatric IBD Network (PIBDNet), we compared global pediatric IBD anti-TNF practice patterns. Methods. Physicians were surveyed about anti-TNF use in Crohn’s disease (CD) and ulcerative colitis (UC). Chi-squared, independent samples Mann–Whitney U, or related samples Wilcoxon signed rank tests were used to compare groups. Results. 344 physicians treating pediatric IBD responded from 43 countries (54% North America, 29% Europe, 6% Oceania, 6% Asia, 3% Africa, and 2% South America). Respondents treated a median 40 IBD patients. CD was more commonly treated with anti-TNF than UC (40% vs. 10%, p<0.001). North Americans more often used anti-TNF (median 50% vs. 30%, p<0.001) and before immunomodulator (80% vs. 35% CD, p<0.001; 76% vs. 43% steroid-dependent UC, p<0.001). Anti-TNF monotherapy was more common in North America. Anti-TNF in combination with methotrexate, instead of thiopurine, characterized North American practices. North Americans more often continued immunomodulator indefinitely and less often adhered to standard infliximab induction dosing. Access limitations were more common outside North America and Europe for both CD (67% vs. 31%, p<0.001) and UC (62% vs. 33%, p<0.001). Conclusions. Anti-TNF use in North America varies significantly from elsewhere. |
| format | Article |
| id | doaj-art-c3d2a16181e14e7183c99349220322c8 |
| institution | Kabale University |
| issn | 2291-2789 2291-2797 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
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| series | Canadian Journal of Gastroenterology and Hepatology |
| spelling | doaj-art-c3d2a16181e14e7183c99349220322c82025-02-03T01:20:49ZengWileyCanadian Journal of Gastroenterology and Hepatology2291-27892291-27972018-01-01201810.1155/2018/31905483190548The Continental Divide: Anti-TNF Use in Pediatric IBD Is Different in North America Compared to Other Parts of the WorldPeter C. Church0Jeffrey Hyams1Frank Ruemmele2Lissy de Ridder3Dan Turner4Anne M. Griffiths5Division of Gastroenterology, Hepatology & Nutrition, The Hospital for Sick Children, Department of Paediatrics, University of Toronto, Toronto, CanadaDivision of Digestive Diseases, Hepatology, and Nutrition, Connecticut Children’s Medical Center, Hartford, CT, USAUniversité Sorbonne Paris Cité, Université Paris Descartes, and Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants malades, Service de Gastroentérologie Pédiatrique, Paris, FranceDepartment of Pediatric Gastroenterology, The Erasmus MC Sophia Children’s Hospital, Rotterdam, NetherlandsThe Juliet Keidan Institute of Pediatric Gastroenterology and Nutrition, Shaare Zedek Medical Center, The Hebrew University of Jerusalem, Jerusalem, IsraelDivision of Gastroenterology, Hepatology & Nutrition, The Hospital for Sick Children, Department of Paediatrics, University of Toronto, Toronto, CanadaBackground and Aims. Use of anti-TNF therapies varies internationally. As an initiative of the international Pediatric IBD Network (PIBDNet), we compared global pediatric IBD anti-TNF practice patterns. Methods. Physicians were surveyed about anti-TNF use in Crohn’s disease (CD) and ulcerative colitis (UC). Chi-squared, independent samples Mann–Whitney U, or related samples Wilcoxon signed rank tests were used to compare groups. Results. 344 physicians treating pediatric IBD responded from 43 countries (54% North America, 29% Europe, 6% Oceania, 6% Asia, 3% Africa, and 2% South America). Respondents treated a median 40 IBD patients. CD was more commonly treated with anti-TNF than UC (40% vs. 10%, p<0.001). North Americans more often used anti-TNF (median 50% vs. 30%, p<0.001) and before immunomodulator (80% vs. 35% CD, p<0.001; 76% vs. 43% steroid-dependent UC, p<0.001). Anti-TNF monotherapy was more common in North America. Anti-TNF in combination with methotrexate, instead of thiopurine, characterized North American practices. North Americans more often continued immunomodulator indefinitely and less often adhered to standard infliximab induction dosing. Access limitations were more common outside North America and Europe for both CD (67% vs. 31%, p<0.001) and UC (62% vs. 33%, p<0.001). Conclusions. Anti-TNF use in North America varies significantly from elsewhere.http://dx.doi.org/10.1155/2018/3190548 |
| spellingShingle | Peter C. Church Jeffrey Hyams Frank Ruemmele Lissy de Ridder Dan Turner Anne M. Griffiths The Continental Divide: Anti-TNF Use in Pediatric IBD Is Different in North America Compared to Other Parts of the World Canadian Journal of Gastroenterology and Hepatology |
| title | The Continental Divide: Anti-TNF Use in Pediatric IBD Is Different in North America Compared to Other Parts of the World |
| title_full | The Continental Divide: Anti-TNF Use in Pediatric IBD Is Different in North America Compared to Other Parts of the World |
| title_fullStr | The Continental Divide: Anti-TNF Use in Pediatric IBD Is Different in North America Compared to Other Parts of the World |
| title_full_unstemmed | The Continental Divide: Anti-TNF Use in Pediatric IBD Is Different in North America Compared to Other Parts of the World |
| title_short | The Continental Divide: Anti-TNF Use in Pediatric IBD Is Different in North America Compared to Other Parts of the World |
| title_sort | continental divide anti tnf use in pediatric ibd is different in north america compared to other parts of the world |
| url | http://dx.doi.org/10.1155/2018/3190548 |
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