Health Technology Assessment of Infliximab: A Rapid Review of Type 2 Studies

Abstract

Background: Infliximab has been used for treatment of patients with Crohn's disease whose symptoms or developed fistula could not be eliminated by standard treatments. Methods: We evaluated studies which compared infliximab with other treatment methods for Crohn's disease in terms of drug safety, efficacy, and cost effectiveness. We searched Cochrane Library (Issue 3, 2011) for articles published from the beginning of 2009 to October 2011. Results were analyzed using qualitative methods. Findings: Infliximab had the highest effectiveness in the treatment of Crohn's disease with fistula. The rate was slightly higher in the treatment of acute Crohn's disease symptoms than in maintenance therapy (29-42% vs. 23%). Infliximab is potentially more cost-effective than alternative drugs, such as adalimumab, in patients with Crohn's disease who had complex fistula. The cost-effectiveness ratio of infliximab is in fact above £50,000 per quality-adjusted life year (QALY) for patients without fistula and over £100,000 per QALY for patients with fistula. Conclusion: Infliximab is a relatively safe drug which is most effective and cost-effective in the treatment of severe complicated Crohn's disease with fistula in patients with acute symptoms. Keywords: Crohn's disease, Infliximab, Anti-tumor necrosis factor