Charlène Duchesne1, Patrick Faure2, François Kohler3, Marie-Pierre Pingannaud4, Guillaume Bonnaud5, Franck Devulder6, Laurent Abramowitz7, Christian Boustière8, Laurent Peyrin-Biroulet9. 1. INSERM U954 and Department of Hepato-Gastroenterology, Université de Lorraine, France. 2. Department of Hepato-Gastroenterology, Clinic St Jean Languedoc, Toulouse, France. 3. SPI-EAO Laboratory, Faculty of Medicine, Nancy, France. 4. 23 Cours Gouffé, Marseille, France. 5. Department of Hepato-Gastroenterology, Clinic des Cèdres, Cornebarrieu, France. 6. Department of Hepato-Gastroenterology, Clinic de Courlancy, Reims, France. 7. Proctological Unit, Gastroenterological Service of CHU Bichat, APHP, Paris and Blomet Clinic, Paris, France. 8. 2 Allée Robert Govi, Aubagne, France. 9. INSERM U954 and Department of Hepato-Gastroenterology, Université de Lorraine, France. Electronic address: peyrinbiroulet@gmail.com.
Abstract
BACKGROUND: Data on the current management of inflammatory bowel disease are scarce. METHODS: This was a nationwide survey among 65 private gastroenterologists treating patients with inflammatory bowel disease in France in 2012. RESULTS: A total of 375 inflammatory bowel disease patients were analysed: 48% had ulcerative colitis. One third of inflammatory bowel disease patients had a history of hospitalisation, and 40% of Crohn's disease patients had prior surgery. Two thirds of inflammatory bowel disease patients had active disease. Significantly fewer ulcerative colitis patients were treated with anti-tumour necrosis factor therapy than Crohn's disease patients (18.9% vs. 38.9%; p<0.0001). Among patients treated with anti-tumour necrosis factor, only 4.5% were receiving concomitant immunomodulators. Half of inflammatory bowel disease patients had undergone a colonoscopy within the past year. For colorectal cancer screening, random biopsies and chromoendoscopy were performed in 75% and 40% of cases, respectively. An endoscopic score was used for only 10% of inflammatory bowel disease patients. About one third of inflammatory bowel disease patients had imaging studies within the past year (magnetic resonance enterography in 65%). An abdominal computed tomography scan was prescribed for 12% of inflammatory bowel disease patients. CONCLUSIONS: Many patients still have active disease in the biologics era, and the number of patients receiving combination therapy is low in private practice. Chromoendoscopy and endoscopy scores are not often used.
BACKGROUND: Data on the current management of inflammatory bowel disease are scarce. METHODS: This was a nationwide survey among 65 private gastroenterologists treating patients with inflammatory bowel disease in France in 2012. RESULTS: A total of 375 inflammatory bowel diseasepatients were analysed: 48% had ulcerative colitis. One third of inflammatory bowel diseasepatients had a history of hospitalisation, and 40% of Crohn's diseasepatients had prior surgery. Two thirds of inflammatory bowel diseasepatients had active disease. Significantly fewer ulcerative colitispatients were treated with anti-tumour necrosis factor therapy than Crohn's diseasepatients (18.9% vs. 38.9%; p<0.0001). Among patients treated with anti-tumour necrosis factor, only 4.5% were receiving concomitant immunomodulators. Half of inflammatory bowel diseasepatients had undergone a colonoscopy within the past year. For colorectal cancer screening, random biopsies and chromoendoscopy were performed in 75% and 40% of cases, respectively. An endoscopic score was used for only 10% of inflammatory bowel diseasepatients. About one third of inflammatory bowel diseasepatients had imaging studies within the past year (magnetic resonance enterography in 65%). An abdominal computed tomography scan was prescribed for 12% of inflammatory bowel diseasepatients. CONCLUSIONS: Many patients still have active disease in the biologics era, and the number of patients receiving combination therapy is low in private practice. Chromoendoscopy and endoscopy scores are not often used.