caa a22 4500 445796146 CHVBK 20180317145125.0 cr unu---uuuuu 170323e20110401xx s 000 0 eng 10.1007/s10620-010-1530-9 doi (NATIONALLICENCE)springer-10.1007/s10620-010-1530-9 Practice Patterns in the Use of Anti-Tumor Necrosis Factor Alpha Agents in the Management of Crohn's Disease: A US National Practice Survey Comparing Experts and Non-Experts [Elektronische Daten] [Arun Swaminath, Benjamin Lebwohl, Kristina Capiak, Daniel Present] Background: The US Food and Drug Administration currently approves three types of anti-tumor necrosis factor α (anti-TNFα) therapy for treatment of moderate to severe Crohn's disease. There are no guidelines to clarify which of the drugs may be better suited to individual clinical scenarios. Aims: We gathered national data on the prescribing pattern, comfort levels, and algorithms gastroenterologists use for management of their biologic-requiring Crohn's disease patients. Methods: An internet survey was mailed to members of the American Gastroenterology Association. Responses were separated into "non-expert” and "expert” physician groups on the basis of whether a practice consisted of >50% of patients with inflammatory bowel disease. We compared experts with non-experts with regard to the use of the three anti-TNF agents, attitudes regarding their relative efficacy, and their experience with adverse events. Results: Of 3,990 eligible gastroenterologists, 473 replied in full (11.9%). Sixty (12.6%) respondents met the criterion for IBD expert physician. Experts were comfortable using both immunomodulators and anti-TNFα therapy. Community physicians were equally comfortable prescribing 6-mercaptopurine, azathioprine, infliximab, and adalimumab, but less comfortable than experts with methotrexate (56 vs. 86%, P<0.05) and certolizumab (68 vs. 89%, P<0.05). Expert physicians were much more likely to have encountered adverse reactions to anti-TNFα therapy. Conclusions: Our results suggest that experts are more comfortable using a broader array of medical therapy than non-expert physicians. Although both groups had similar concerns regarding side-effects of anti-TNFα therapy, expert physicians were much more likely to have managed a broad range of complications in their patient population. Springer Science+Business Media, LLC, 2010 Inflammatory bowel disease nationallicence Crohn's disease nationallicence Survey nationallicence TNF alpha nationallicence Biologics nationallicence Continuous quality improvement nationallicence Swaminath Arun Department of Medicine, Division of Digestive and Liver Diseases, Columbia University Medical Center, 622 West 168th Street, PH 20-303, 10032, New York, NY, USA aut Lebwohl Benjamin Department of Medicine, Division of Digestive and Liver Diseases, Columbia University Medical Center, 180 Ft. Washington Ave, Suite 936, 10032, New York, NY, USA aut Capiak Kristina Division of Digestive and Liver Diseases, Columbia University Medical Center, 622 West 168th Street, PH 20-319, 10032, New York, NY, USA aut Present Daniel Department of Medicine, Henry D Janowitz Division of Gastroenterology, Mount Sinai Medical Center, 12 East 86th Street, Frnt 1, 10028, New York, NY, USA aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/4(2011-04-01), 1160-1164 0163-2116 56:4<1160 2011 56 10620 https://doi.org/10.1007/s10620-010-1530-9 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-010-1530-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Swaminath Arun Department of Medicine, Division of Digestive and Liver Diseases, Columbia University Medical Center, 622 West 168th Street, PH 20-303, 10032, New York, NY, USA aut NATIONALLICENCE 700 1- Lebwohl Benjamin Department of Medicine, Division of Digestive and Liver Diseases, Columbia University Medical Center, 180 Ft. Washington Ave, Suite 936, 10032, New York, NY, USA aut NATIONALLICENCE 700 1- Capiak Kristina Division of Digestive and Liver Diseases, Columbia University Medical Center, 622 West 168th Street, PH 20-319, 10032, New York, NY, USA aut NATIONALLICENCE 700 1- Present Daniel Department of Medicine, Henry D Janowitz Division of Gastroenterology, Mount Sinai Medical Center, 12 East 86th Street, Frnt 1, 10028, New York, NY, USA aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/4(2011-04-01), 1160-1164 0163-2116 56:4<1160 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer