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• W2325992023 abstract "In Japan, infliximab (IFX) has been introduced for both remission induction and maintenance therapy in patients with refractory Crohn's disease (CD), but as yet not for patients with ulcerative colitis (UC), while leukocytapheresis (LCA) is accepted for severe active UC. Further, an interesting trial has been reported from the USA (Inflamm Bowel Dis 2008;14:1-6), which evaluated parents' perceptions of the risks and benefits of infliximab for the treatment of inflammatory bowel disease (IBD). We have evaluated this perception in the Japanese IBD population. Patients with IBD and families attending IBD patient education symposia hosted by the Ministry of Health and Welfare of Japan were asked to complete a questionnaire, which was a modified version of Siegel CA, et al., pertained to the risks and benefits of IFX for CD and LCA for UC. Six hundred and fifty-one questionnaires were completed (43.0% CD and 43.4% UC). The majority or responders (38.0%) expected a significant clinical efficacy rate, >50% at 2 weeks for IFX and 26.5% expected an efficacy rate, >70%. The corresponding values for LCA in UC were 29.3% and 15.0%, respectively. More than onefourth (26.5%) of participants expected IFX to maintain clinical remission in CD for >1 year. Almost half (46.4%) of the participants responded that IFX is not associated with a risk of lymphoma and another 30% thought that the lymphoma risk is not higher than twice the rate in the general population. When presented with a scenario in which of a hypothetical new drug for IBD had a fatal risk of 0.004% (mirroring the estimated level for IFX), 59% of responders indicated that they would not take it, despite a setting remission rate of 90% in 1 year. More than half (53%) of the responders did not agree to pay $500/month for the hypothetical drug although it had a set remission rate of 75% for 1 year. A new era of biologic therapy for IBD has just begun in Japan. Our investigation showed that the responders in Japan overestimated the benefit of IFX; in contrast, they underestimated its risks. Additionally, given that the current Japanese health insurance scheme covers almost the complete treatment cost for IBD, including IFX for CD, the responders did not take a positive view on bearing the cost of an effective new drug. One could assume a significant difference in ethical and thinking cultures among populations. We conclude that appropriate methods and/or opportunity for patients to realistically recognize the risks and benefits of therapy might be valuable for establishing a perpetual nationwide strategy." @default.
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• W2325992023 date "2009-12-01" @default.
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• W2325992023 title "The perceptions of risks and benefits of Infliximab and Leukocytapheresis by Japanese patients with Inflammatory Bowel Disease" @default.
• W2325992023 doi "https://doi.org/10.1097/00054725-200912002-00056" @default.
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