Are Patients with Inflammatory Bowel Disease Receiving Optimal Care?

Abstract

Patients with IBD often do not receive optimal medical therapy. In particular, there is suboptimal dosing of 5-ASA and immunomodulatory medications, prolonged use of corticosteroids, failure to use steroid-sparing agents, inadequate measures to prevent metabolic bone disease, and inadequate screening for colorectal cancer.

Current use of immunosuppressive agents in inflammatory bowel disease patients in East China

“…In recent years, because of the rapid development of evidence-based medicine, the therapy guidelines of IBD in China and abroad have been updated constantly. Reddy et al [12] analyzed the therapeutic condition of American patients with IBD according to the American College of Gastroenterology (ACG) practice guidelines [13,14] . They found that the dose of aminosalicylic acid agents was not adequate and enema therapy and immunosuppressive agents were not applied effectively [13,14] .…”

Manejo integral de la enfermedad inflamatoria intestinal: más allá de una terapia farmacológica adecuada

“…Reddy et al han sugerido que pacientes con EII a menudo no reciben un tratamiento adecuado, lo que se traduce en dosis subóptimas de mesalazina e inmunosupresores, prolongado uso de esteroides y suplementos de calcio y vitamina D, inadecuada vigilancia de cáncer colorrectal y ausencia de indicación de vacunas 44 . Por otra parte, la percepción de los pacientes con EII sobre la calidad de la atención que ellos tienen está determinada por la presencia de factores pronósticos y por el tipo de terapia que reciben para el manejo de su enfermedad 45 .…”

Can azathioprine/6-mercaptopurine treatment be withdrawn in patients with response in ulcerative colitis: What is the most appropriate time for this?

“…Actual IMM doses were found to be inappropriately low in 80% of the cases (18). In another study about IMM, indications and protocols were inappropriate in 78% of the cases (19).…”