title: Conditions of prescription of anti-TNF agents in newly treated patients with inflammatory bowel disease in France (2011-2013).
abstract: BACKGROUND
  Tumour necrosis factor inhibitors (anti-TNFs) are active but expensive drugs that induce and maintain remission in patients with Crohn's disease (CD) and ulcerative colitis (UC).
  
  
  OBJECTIVE
  To assess the trends in anti-TNF prescription and the conditions of prescription of these drugs in patients with inflammatory bowel disease (IBD) in France.
  
  
  METHODS
  Incidence study of anti-TNF use was performed based on French medico-administrative databases (SNIIRAM/PMSI). IBD patients who initiated adalimumab or infliximab between 2011 and 2013 were selected.
  
  
  RESULTS
  The number of new anti-TNF users increased from 4571 to 5875 between 2011 and 2013 (+29%). More specifically, the number of patients not treated with immunosuppressants (IS) during the previous 12 months increased from 2100 to 3007 (+43%), among whom 379 patients in 2011 and 570 patients in 2013 started combination therapy (+50%). These trends were observed for both CD and UC. Patients who were naïve of IS were hospitalised more frequently than those treated with IS prior to anti-TNF therapy.
  
  
  CONCLUSIONS
  This study shows a rapid increase in new prescriptions of anti-TNF for both CD and UC in France between 2011 and 2013. These results suggest a change in medical practices, with anti-TNF agents prescribed more often as first-line maintenance treatment.
authors.affiliation: French National Health Insurance (CNAMTS), Paris, France.
authors.forename: Pierre-Olivier
authors.initials: PO
authors.lastname: Blotière
authors.affiliation: French National Health Insurance (CNAMTS), Paris, France. Electronic address: jeremie.rudant@cnamts.fr.
authors.forename: Jérémie
authors.initials: J
authors.lastname: Rudant
authors.affiliation: Université Paris Sud and Gastroenterology Unit, Hôpitaux Universitaires Paris Sud, CHU de Bicêtre, AP-HP, Le Kremlin Bicêtre, France.
authors.forename: Amélie
authors.initials: A
authors.lastname: Barré
authors.affiliation: Université Paris Sud and Gastroenterology Unit, Hôpitaux Universitaires Paris Sud, CHU de Bicêtre, AP-HP, Le Kremlin Bicêtre, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Racine
authors.affiliation: French National Health Insurance (CNAMTS), Paris, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Weill
authors.affiliation: Inserm U954, Department of Hepato-Gastroenterology, University Hospital of Nancy, Lorraine University, Vandoeuvre-Les-Nancy, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Peyrin-Biroulet
authors.affiliation: Université Paris Sud and Gastroenterology Unit, Hôpitaux Universitaires Paris Sud, CHU de Bicêtre, AP-HP, Le Kremlin Bicêtre, France.
authors.forename: Franck
authors.initials: F
authors.lastname: Carbonnel
authors.affiliation: French National Health Insurance (CNAMTS), Paris, France.
authors.forename: François
authors.initials: F
authors.lastname: Alla
mesh_terms: D000068879:Adalimumab / Q000627:therapeutic use*; D000328:Adult; D015331:Cohort Studies; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D003424:Crohn Disease / Q000188:drug therapy*; D016208:Databases, Factual; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D005602:France; D006801:Humans; D000069285:Infliximab / Q000627:therapeutic use*; D008297:Male; D010818:Practice Patterns, Physicians' / Q000639:trends*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab
keywords: Crohn's disease; Healthcare resource use; Trends; Ulcerative colitis