The Crohn's Disease–Ulcerative Colitis Clinical Appraisal (2016)

The frequent publication of clinical study data impacts the practice of evidence-based medicine in inflammatory bowel disease (IBD) management. Interpreting and incorporating these data into daily clinical practice are challenging. To assess the relative strength and limitations of our current knowledge in IBD, a systematic clinical appraisal of the medical literature was conducted by a panel of IBD leaders that was chaired by Prof Geert D’Haens of the Inflammatory Bowel Disease Centre of the Academic Medical Centre in Amsterdam. Results of this literature appraisal were then compared with the results of an international clinical practice survey of gastroenterologists to reveal any discrepancies between published evidence and current clinical practice. The treatment areas addressed in both the literature appraisal and the gastroenterologist survey included anti–tumor necrosis factor-α therapy, definitions of treatment failure, use of drug levels, and long-term risks of therapy. Gastroenterologists were asked via an e-mailed survey to vote on 6 clinical scenario statements by using a Likert scale of acceptance or rejection. Concurrently, the panel of IBD leaders critically appraised the existing medical literature to assess the relative strength and limitations related to each statement and voted on the same statements by using the same Likert scale. Voting results from the survey and the panel were compared and analyzed. The panel’s analysis and discussion of the literature produced additional questions for consideration. All respondents to the gastroenterologist survey were in practice, and approximately 74% reported spending ≥25% of their time managing IBD patients. Discordant voting between the panel and the surveyed gastroenterologists revealed there are unmet educational needs to enhance the level of knowledge surrounding difficult questions in IBD management. Voting results for all 6 statements are presented in this interactive publication http://education.cghjournal.org/video/976/5/CD-UC-clinical-appraisal. See how your practice patterns and views compare with those of your peers and the panel of IBD leaders. The faculty who participated in this multimedia activity have disclosed the following industry relationships: Geert D’Haens, MD, PhD, has received grant/research support from Abbott Laboratories, Dr Falk Pharma, Given Imaging, Janssen Biologics, MSD, Photopill. He is a consultant/speaker for AbbVie, Abbott Laboratories, ActoGeniX, AM Pharma, Boehringer Ingelheim GmbH, Centocor, ChemoCentryx, Cosmo Technologies, Elan, Engene, Dr Falk Pharma, Ferring, Galapagos, Giuliani SpA, Given Imaging, GlaxoSmithKline, Janssen Biologics, Merck Sharp and Dohme Corp, Millennium (Takeda), MSD, Neovacs, Novo Nordisk, Norgine, Otsuka, PDL Biopharma, Pfizer, Receptos, Salix, Setpoint, Shire, Schering-Plough, Tillotts, Tramedico Pharma, UCB, Versant, and Vifor. Brian Bressler, MD, has received grant/research support from AbbVie, Alvine, Amgen, AstraZeneca, BMS, Gilead, GSK, Janssen, Merck, Sanofi Aventis, and Takeda. He is a consultant/speaker for AbbVie, Alpco, Aptalis, Ferring, Janssen, Takeda, Shire, and Warner Chilcott. Silvio Danese, MD, is a consultant/speaker for Abbott Laboratories, AbbVie, Actelion, Alfa Wasserman, Astra Zeneca, Cellerix, Celtrion, Cosmo, Ferring, Genentech, Grunenthal, Johnson and Johnson, Merck & Co, Millenium, Novo Nordisk, Nycomed, Pharmacosmos, Pfizer, Schering-Plough, Takeda, Tigenix, UCB, and Vifor. Peter Gibson, MD, has received grant/research support from AbbVie, Ferring, Fresenius Kabi, Janssen, and Orphan Australia. He is a consultant/speaker for AbbVie, Danone, AstraZeneca, Ferring, Janssen, and Takeda. Stephen B. Hanauer, MD, has received grant/research support from AbbVie, Janssen, and Takeda. He is a consultant/speaker for AbbVie, Janssen, Millennium, Takeda, and UCB. William Sandborn, MD, has received grant/research support from Abbott, Bristol-Myers Squibb, Genentech, GSK, Janssen, Millennium, Novartis, Pfizer, Procter and Gamble, Shire, and UCB. He is a consultant/speaker for Abbott, ActoGeniX NV, AGI Therapeutics Inc, Alba Therapeutics Corp, Albireo, Alfa Wasserman, Amgen, AM-Pharma BV, Anaphore, Astellas, Athersys Inc, Atlantic Healthcare Ltd, Aptalis, BioBalance Corp, Boehringer-Ingelheim, Bristol-Myers Squibb, Celgene, Celek, Cellerix SL, Cerimon, ChemoCentryx, CoMentis, Cosmo Technologies, Coronado Biosciences, Cytokine Pharmasciences, Eagle, EnGene Inc, Eli Lilly, Enteromedics, Exagen Diagnostics Inc, Ferring, Flexio Therapeutics Inc, Funxional Therapeutics Ltd, Genzyme Corp, Gilead Sciences, Given Imaging, GSK, Human Genome Sciences, Ironwood, Janssen, KaloBios, Lexicon, Lycera Corp, Meda, Merck Research Laboratories, Merck Serono, Millenium, Nisshin Kyorin, Novo Nordisk, NPS, Optimer, Orexigen, PDL Biopharma, Pfizer, Procter and Gamble, Prometheus Laboratories, ProtAb Ltd, Purgenesis Technologies Inc, Relypsa Inc, Roche, Salient, Salix, Santarus, Schering Plough, Shire, Sigmoid Pharma Ltd, Sirtris, SLA Pharma UK Ltd, Targacept, Teva, Therakos, Tillotts Pharma AG, TxCell SA, UCB, Viamet, Vascular Biogenics Ltd, Warner Chilcott UK Ltd, and Wyeth.