Early Biologic Treatment versus Conventional Treatment for the Management of Crohn’s Disease: A Review of Comparative Clinical Effectiveness and Cost-Effectiveness

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Project Line:
Health Technology Review
Project Sub Line:
Peer-reviewed Summary with Critical Appraisal
Project Number:
RD0050-000

Question

  1. What is the clinical effectiveness of early biologic treatment compared with conventional treatment for the management of Crohn’s disease?
  2. What is the cost-effectiveness of early biologic treatment compared with conventional treatment for the management of Crohn’s disease?

Key Message

The clinical effectiveness of early biologic therapy compared to conventional therapy for Crohn’s disease in adults is unclear based on available evidence, due to a limited number of studies and heterogeneity of existing studies. The evidence identified in this report did not suggest consistent benefits of early biologic therapy compared to conventional treatment but did point to possible benefits which require further study. There were six non-randomized studies conducted in children, which were limited both in terms of the size and quality. No firm conclusions can be drawn about the clinical effectiveness of early biologic therapy for Crohn’s disease based on current evidence. One cost-effectiveness analysis conducted in Italy suggested that early combined therapy may be both more effective and cost-saving compared to conventional treatment for Crohn’s disease in adults.