National clinical audit report of biological therapies - Adult report 2013

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This is the first full national report of the biological therapy element of the UK IBD audit and all analyses within this report include only those patients that were newly started on biological therapies between 12 September 2011 (start of data collection) and 28 February 2013.

Key recommendations

  1. Sites should continue to participate in national audit and aim to submit data on all appropriate patients.
  2. All patients receiving biological therapy should be screened for tuberculosis, hepatitis B and C, HIV and varicella before treatment is commenced, in keeping with current guidelines (NICE and ECCO).
  3. 160/80mgs of Adalimumab should be used for induction therapy.
  4. Hydrocortisone should not be routinely given prior to Infliximab infusions.
  5. Shortened Infliximab infusion times for maintenance treatment should be considered as a useful way to streamline services and improve patient care.
  6. Clinicians should be vigilant in screening for opportunistic infection and treatment should be started promptly.
  7. Sites should routinely assess disease activity at baseline and again at 3 and 12 month follow up, this measure forms an important part of objectively assessing response to treatment and the quality of care provided by the IBD service.
  8. Local teams should encourage patients to complete patient reported outcome measures (EQ-5D and CCQ12) at baseline and again at 3 and 12 month follow up, this measure also forms an important part of objectively assessing response to treatment and the quality of care provided by the IBD service.
  9. Sites participating in the audit should export their own local data and use this for local analyses, benchmarking and quality improvement activities.
  10. The findings and recommendations of this report should be shared at relevant multi-disciplinary and clinical governance / audit meetings.