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A systematic review and economic evaluation of the use of tumour necrosis factor-alpha (TNF-α) inhibitors, adalimumab and infliximab, for Crohn’s disease
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Dretzke, J., Edlin, R., Round, J., Connock, M., Hulme, C., Czeczot, J., Fry-Smith, A., McCabe, Chris and Meads, C. (2011) A systematic review and economic evaluation of the use of tumour necrosis factor-alpha (TNF-α) inhibitors, adalimumab and infliximab, for Crohn’s disease. Health Technology Assessment, Vol.15 (No.6). pp. 1-244. ISSN 1366-5278.
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Official URL: http://www.hta.ac.uk/execsumm/summ1506.htm
Abstract
Crohn’s disease (CD) is a severe, lifelong disease characterised by inflammation of the gastrointestinal mucosa. Main symptoms include chronic diarrhoea, abdominal pain, rectal bleeding and weight loss, and growth failure in children. Common complications are strictures (narrowing of the bowel), fistulas (creation of abnormal passageways between the bowel and other structures) and perianal disease (comprising fissures, fistulas and abscesses). The disease is characterised by recurring flares of variable duration alternating with periods of remission of variable duration. There is no cure and most patients will need to take medication for large periods of their life and many will require surgery. CD manifests itself mainly during late adolescence or early adulthood; prevalence estimates range from 50 to 375 per 100,000. The impact on patients and society is high as ill health can be lifelong and can negatively affect education and employment as well as patients’ quality of life. Costs to the NHS are high, particularly for patients needing hospitalisation.
Conventional treatment pathways are complex and include a wide range of drugs (corticosteroids, aminosalicylates, immunosuppressants, antibiotics), nutritional therapy and surgery. More recently, a group of drugs called tumour necrosis factor (TNF) inhibitors (anti-TNF-α agents) have been evaluated for their effectiveness in CD. One of these, infliximab, is currently recommended by the National Institute for Health and Clinical Excellence (NICE; 2002) for patients with severe, active CD where patients are refractory to or intolerant of conventional treatment.
Item Type: | Journal Article | ||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) > Warwick Evidence Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | Health Technology Assessment | ||||
Publisher: | National Coordinating Centre for Health Technology Assessment | ||||
ISSN: | 1366-5278 | ||||
Official Date: | 2011 | ||||
Dates: |
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Volume: | Vol.15 | ||||
Number: | No.6 | ||||
Page Range: | pp. 1-244 | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published |
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