National clinical audit report of biological therapies - Paediatric report 2014

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This is the third biological therapy report published from the UK IBD audit. The report is addressed to anyone who is interested in IBD. It publishes national‐ and hospital‐level findings on the efficacy, safety and appropriate use of biological therapies for patients newly started on biologics since its inception, 12 September 2011 – 28 February 2014.

Key recommendations

  1. Sites should continue to participate in the national biological therapy audit and aim to submit data on all appropriate patients wherever possible.
  2. Sites should routinely assess disease activity at baseline and again at 3‐ and 12‐month follow‐up. This measure is a vital part of objective assessment of the appropriateness of initial treatment, response and whether ongoing treatment is still clinically appropriate.
  3. The PCDAI may not fully capture the appropriateness of biologics treatment for all patients based on current clinical use. Using different disease activity assessments, such as the Weighted Paediatric Crohn’s Disease Activity Index (wPCDAI)4 or PGA, or combining assessment with other parameters may help to address this issue.
  4. Local teams should encourage patients to complete IMPACT III, patient‐reported outcome measure at baseline and again at 3‐ and 12‐month follow‐up; this measure also forms an important part of objective assessment of response to treatment and the quality of care provided by the IBD service.
  5. Sites participating in the audit should export their own local data and use them for local analyses, benchmarking and local quality improvement activities.
  6. The findings and recommendations of this report should be shared at relevant multidisciplinary and clinical governance / audit meetings, and local action plans for implementing change should be devised.