The use of anti-TNF therapy in the management of Crohn's disease and, to a lesser extent ulcerative colitis, is increasing. This article aims to discuss the practicalities of establishing a biologics service for patients with inflammatory bowel disease. Current guidelines on the use of these drugs are reviewed followed by a discussion on the choice of which anti-TNF agent to use based on costs and patient choice. A model for the initiation, administration, monitoring and assessment of patients receiving anti-TNF therapy is proposed. The need for a national biologics registry is highlighted in the summary.
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Competing interests PJH and SME were both advisory board members for Schering Plough/MSD and Abbott pharmaceuticals. PJH advised on the draft NICE benchmarking guide for commissioning of anti-TNF therapies. Schering Plough/MSD provided the salary for an IBD clinical nurse specialist in Leeds.
Provenance and peer review Not commissioned; externally peer reviewed.
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