Intest Res.  2009 Dec;7(2):79-85.

A Survey of Actual Clinical Practice Patterns in the Treatment of Inflammatory Bowel Disease in Korea

Affiliations
  • 1Department of Internal Medicine, Dongguk University College of Medicine, Goyang, Korea.
  • 2Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea. geniushee@yuhs.ac

Abstract

BACKGROUND/AIMS
The aim of this study was to determine the actual practice patterns of clinicians caring for Korean patients with inflammatory bowel diseases (IBDs).
METHODS
Questionnaires, including te indications and doses of 5-aminosalicylic acid (5-ASA), corticosteroids, or azathioprine/6-mercaptopurine (AZA/6-MP), assessment of response, the surveillance method, and the interval for adverse effects, were distributed during the 2008 KASID annual lecture. Thirty questionnaires were collected.
RESULTS
Most of the responders (93.3%) were board-certified with sub-specialty training in gastroenterology. For active diseases, 43.3% of the responders escalated the dose of 5-ASA from conventional to maximal doses. Of the patients in disease remission, 36.7% were maintained on the conventional or a reduced dose for a fixed period of time. Corticosteroids were prescribed by dose-base (20/30 [66.7%]). In most cases, the starting dose was 40 mg/d (15/19 [78.9%]), and tapered within a 1 (43.3%) or 2 week interval (40.0%). There were various definitions of corticosteroid-refractoriness and -dependency among the responders. Most of the responders initiated AZA at 50 mg/d; 68.4% of the patients increased the dose by 25 mg and 55.6% of the patients increased the dose within a 4-week interval. For monitoring adverse events, such as leukopenia, 63.3% of the patients checked a complete blood count for 2 weeks in the 1st month of therapy.
CONCLUSIONS
There were various patterns of practice in the treatment of Korean IBD patients, especially in terms of the prescribing patterns of drugs and assessment of response, which suggests that standard therapeutic guidelines of IBD should be established in Korea.

Keyword

Inflammatory Bowel Diseases; Aminosalicylic Acids; Glucocorticoids; Azathioprine

MeSH Terms

Adrenal Cortex Hormones
Aminosalicylic Acids
Azathioprine
Blood Cell Count
Gastroenterology
Glucocorticoids
Humans
Inflammatory Bowel Diseases
Korea
Leukopenia
Mesalamine
Physician's Practice Patterns
Surveys and Questionnaires
Adrenal Cortex Hormones
Aminosalicylic Acids
Azathioprine
Glucocorticoids
Mesalamine
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