Defining partial response in inflammatory bowel disease: a Delphi consensus and economic evaluation.

Area of Science:

• Gastroenterology and Hepatology
• Clinical Medicine
• Inflammatory Bowel Disease Research

Background:

• Therapeutic goals in inflammatory bowel disease (IBD) are evolving with new treatments and diagnostics.
• Despite advancements, significant unmet clinical needs persist in IBD management.
• A clear definition of treatment response is essential for optimizing patient care.

Purpose of the Study:

• To establish a consensus definition for "partial responders" in clinical practice for IBD.
• To differentiate patients who do not meet defined therapeutic objectives within the expected timeframe.
• To provide clear criteria for assessing treatment efficacy in various IBD scenarios.

Main Methods:

• A two-round Delphi consultation involving 60 IBD-specialized gastroenterologists in Spain.
• A 22-item questionnaire addressing four clinical scenarios: moderate ulcerative colitis (UC), acute severe UC, luminal Crohn's disease (CD), and perianal CD.
• Consensus defined as agreement by ⩾70% of panelists using a 7-point Likert scale; analysis of associated annual costs for partial responders versus remission.

Main Results:

• Consensus was reached on definitions for partial response in UC and CD, incorporating clinical scores, biomarkers, and imaging/endoscopic findings.
• Estimated annual costs for partial responders were significantly higher than for patients in remission: €2570.40 (UC) vs €820.20, €1607.30 (luminal CD) vs €718.0, and €2886.70 (perianal CD) vs €888.80.
• Achieving prolonged remission could yield substantial savings (55%-70%) in non-pharmacological resource use and associated costs.

Conclusions:

• Formal definitions for partial responders have been established across four key IBD clinical scenarios.
• These definitions can aid healthcare professionals in clinical decision-making and patient management.
• Improved patient care and potential cost savings are achievable through better identification and management of treatment response in IBD.