In a Danish nationwide cohort of patients with CD, the prevalence of perianal fistulas decreased in the period from 2010 to 2016. The reason for this needs further elucidation. Only half of the incident cases received biologicals, yet biological treatment was the main expenditure for the entire study population. Healthcare costs for pCF decreased during the study period, but are still high compared with non-pCF IBD patients.  

This study,  a register-based Danish population study, investigated the average annual healthcare costs and production values of patients 10 years before and 8 years after diagnosis, and after initiating biologic treatment.

Increased risk of both cancer and suicide

Patients with inflammatory bowel disease diagnosed in childhood are at an increased risk of both cancer and mortality compared to the background population. While cancer is the leading cause of death, the risk of suicide is markedly increased.  

Prospective studies specifically assessing the effectiveness and safety profile of current therapeutic strategies based on a wider use of biologics in inflammatory bowel disease (IBD) are lacking. The overall objectives of I-CARE -a European prospective observationalstudy -are to assess: 1) the long-term safety profile (malignancy, infections) of immunomodulators (IMM), biologics (anti-TNF and vedolizumab) alone or in combination with an Iimmunomodulator 2) the potential for disease modification of biologics 3) the benefit-risk ratio of current therapeutic strategies 4) health economics of IBD care  

The prognosis of paediatric onset IBD remains uncertain. In this studi Tine Jess and colleague examined the overall and site-specific cancer risk among paediatric onset IBD patients when compared with non-IBD individuals from the general population. The risk was highest for liver, upper gastrointestinal, small bowel and colorectal cancer and was not influenced by medical treatment. Still, absolute numbers were low with only 1 additional cancer case per 1000 person-years of follow-up. This is important information to patients and clinicians.

In this Norwegian study Bjoern Moum and colleagues aimed to investigate the drug survival of biologics in a national cohort of patients with Crohn’s disease. Data were collected from the Norwegian Patient Registry (NPR) and the Norwegian Prescription Database. In total, 2444 CD patients were included in the study. After 3 years, the survival rate of first-line biologics for CD patients was 50.3% for infliximab and 40.5% for adalimumab (p < 0.001). For second-line treatment, the survival rates were 42.4% for infliximab, 42.8% for adalimumab and 69.8% for vedolizumab. Vedolizumab survival was significantly different compared with adalimumab and infliximab (p < 0.001).  

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