eHealth: individualisation of infliximab treatment and disease course via a self-managed web-based solution in Crohn’s disease

N Pedersen; M Elkjaer; D Duricova; J Burisch; C Dobrzanski; N N Andersen; T Jess; F Bendtsen; E Langholz; S Leotta; T Knudsen; N Thorsgaard; P Munkholm

doi:10.1111/apt.12043

eHealth: individualisation of infliximab treatment and disease course via a self-managed web-based solution in Crohn’s disease

N Pedersen, M Elkjaer, D Duricova, J Burisch, C Dobrzanski, N N Andersen, T Jess, F Bendtsen, E Langholz, S Leotta, T Knudsen, N Thorsgaard, P Munkholm

Abstract

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.

Original language	English
Journal	Alimentary Pharmacology and Therapeutics
Volume	36
Issue number	9
Pages (from-to)	840-9
Number of pages	10
ISSN	0269-2813
DOIs	https://doi.org/10.1111/apt.12043
Publication status	Published - Nov 2012

Keywords

Adolescent
Adult
Aged
Antibodies, Monoclonal/administration & dosage
Crohn Disease/drug therapy
Denmark
Female
Gastrointestinal Agents/administration & dosage
Health Knowledge, Attitudes, Practice
Humans
Infliximab
Internet
Male
Middle Aged
Patient Education as Topic
Pilot Projects
Prospective Studies
Self Administration/methods
Self Care/methods
Severity of Illness Index
Surveys and Questionnaires
Telemedicine
Treatment Outcome
Young Adult

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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. (2012). eHealth: individualisation of infliximab treatment and disease course via a self-managed web-based solution in Crohn’s disease. Alimentary Pharmacology and Therapeutics, 36(9), 840-9. https://doi.org/10.1111/apt.12043

Pedersen, N, Elkjaer, M, Duricova, D, Burisch, J, Dobrzanski, C, Andersen, NN, Jess, T, Bendtsen, F , Langholz, E, Leotta, S, Knudsen, T, Thorsgaard, N & Munkholm, P 2012, 'eHealth: individualisation of infliximab treatment and disease course via a self-managed web-based solution in Crohn’s disease', Alimentary Pharmacology and Therapeutics, vol. 36, no. 9, pp. 840-9. https://doi.org/10.1111/apt.12043

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title = "eHealth: individualisation of infliximab treatment and disease course via a self-managed web-based solution in Crohn{\textquoteright}s disease",

abstract = "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 {\textquoteleft}traffic light{\textquoteright} 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.",

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author = "N Pedersen and M Elkjaer and D Duricova and J Burisch and C Dobrzanski and Andersen, {N N} and T Jess and F Bendtsen and E Langholz and S Leotta and T Knudsen and N Thorsgaard and P Munkholm",

year = "2012",

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doi = "10.1111/apt.12043",

language = "English",

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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

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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.

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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

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DO - 10.1111/apt.12043

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JO - Alimentary Pharmacology and Therapeutics, Supplement

JF - Alimentary Pharmacology and Therapeutics, Supplement

IS - 9

ER -

eHealth: individualisation of infliximab treatment and disease course via a self-managed web-based solution in Crohn’s disease

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Keywords

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