A 10-year survey of inflammatory bowel diseases - drug therapy, costs and adverse reactions

Background: Drug therapy for Crohn's disease and ulcerative colitis is base d on anti-inflammatory and immunodulating drugs, nutritional support and su rgical resection. Recently, new drugs have been introduced. Aim: To report drug prescriptions, costs and adverse reactions among inflam matory bowel disease patients in Sweden between 1988 and 1997. Methods: Drug use was calculated from the national Diagnosis and therapy su rvey and drug costs from prescriptions and drug sales. Adverse drug reactio ns were obtained from the Medical Products Agency's National Pharmacovigila nce system. Results: The annual drug exposure for Crohn's disease was 0.55 million dail y doses per million population, mainly supplementation and aminosalicylic a cids. Mesalazine and olsalazine had 61% within this group. For ulcerative c olitis patients, drug exposure was 0.61 million daily doses per million per year and aminosalicylic acids fell from 70% to 65%. For inflammatory bowel disease patients, corticosteroids and nutritional supplementation were com mon. The annual average cost for inflammatory bowel disease drugs was 7.0 m illion US dollars. Anually, 32 adverse drug reactions were reported, mainly haematological reactions such as agranulocytosis and pancytopenia (60%), f ollowed by skin reactions. Only two deaths were reported. Aminosalicylic ac ids were the most commonly reported compounds. Conclusions: Drug use for inflammatory bowel disease in the pre-biologic ag ent era rested on aminosalicylic acid drugs and corticosteroids with stable levels, proportions and costs. The level of adverse drug reactions was low but haematological reactions support the monitoring of inflammatory bowel disease patients.