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• W2978778751 abstract "Purpose: To assess prescribing practices of gastroenterologists (GIs) treating Crohn's Disease (CD) with adalimumab (ADA), and identify variables associated with FDA-approved ADA dosing. Methods: A survey was developed and tested for content validity by expert review and sent to 13,031 GIs with valid email addresses who are members of the American Gastroenterology Association (AGA) in three email blasts over 6 weeks. Multivariate regression analyses examined relationships between clinical variables and FDA-approved dosing of ADA for CD. Results: 398 (3%) of GIs completed the survey, reporting a mean of 11+/-SD years of GI practice. An academic practice setting was reported by 43%, while 72% prescribe ADA > a few times yearly and 15% follow > 200 CD patients. Ninety percent of GIs believe ADA has a moderate-significantly positive impact on patient care. The FDA-approved ADA induction and maintenance strategy for CD was correctly identified by 82%. Respondents were more likely to prescribe ADA correctly if they followed > 200 CD patients (p=.045) and prescribed ADA > a few times per year (p=.037). Years in practice, practice setting, gender and region did not have a significant impact on prescribing practices. ADA prescribing and dosing practices based on different clinical scenarios (extremes of body weight and prior exposure to infliximab) were assessed. For body weight scenarios, correct ADA dosing was associated with higher frequency of prescribing (p=.014) and CD patient volumes (p=.025). Despite variability in appropriate ADA loading in patients with prior infliximab exposure, no association with ADA prescribing or CD patient volumes was seen on adjusted analyses. Frequency of ADA prescribing and CD patient volumes were predictive of the total number of correct survey answers (p=.014 and p=.017, respectively). Only 50% of GIs always administered loading doses when switching to ADA from another anti-TNF. Of these GIs, 43.5% reported unclear efficacy of loading doses and 24.3% were worried about risk of infection secondary to excess anti-TNF as a reason not to load ADA. Eighteen percent of respondents reported pharmacies had reduced their prescribed ADA doses in the past. Conclusion: Eighteen percent of GIs were not able to correctly identify the FDA approved ADA induction and maintenance strategy. For overall responses and for questions with varied patient weights, GIs who reported using the approved strategy tend to prescribe ADA more frequently and follow more patients with CD in practice. Half of GIs do not load ADA when transitioning from another anti-TNF Further research is needed to confirm our findings and identify barriers to optimal ADA use by GIs for CD. Disclosure: Dr. Flasar - Grant/Research Support: Abbott Laboratories. Dr. Cross - Grant/Research Support: Abbott Laboratories, Advisory Committee/Board Member: Abbott Laboratories, Consultant: Abbott Laboratories, Other: Abbott Laboratories. Ms. Greenberg - none. Dr. Tracy - none. Dr. Rustgi - none Ms. Zullow - none. This research was supported by an industry grant from Abbott Laboratories." @default.
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• W2978778751 date "2012-10-01" @default.
• W2978778751 modified "2023-10-18" @default.
• W2978778751 title "A Health Survey of Gastroenterologist Prescribing Practices with Adalimumab for Crohnʼs Disease" @default.
• W2978778751 doi "https://doi.org/10.14309/00000434-201210001-01617" @default.
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