ArticlePloS one2016
Dose Escalation and Healthcare Resource Use among Ulcerative Colitis Patients Treated with Adalimumab in English Hospitals: An Analysis of Real-World Data.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- A Systematic Review of the Economic and Health-Related Quality of Life Impact of Advanced Therapies Used to Treat Moderate-to-Severe Ulcerative Colitis.Advances in therapy · 2023Pooled it
- Benefit-Risk Trade-offs and Patient Preferences for Therapy Selection in Ulcerative Colitis: a Multicountry Preference Study.Inflammatory bowel diseases · 2025Article
- Real-World Dose Escalation and Associated Direct Costs of Biologics in Management of Ulcerative Colitis: A Retrospective Database Study.Digestive diseases (Basel, Switzerland) · 2025Article
- Dose Escalation Patterns and Associated Costs of Advanced Therapies for Ulcerative Colitis in France and the United Kingdom: A Retrospective Database Analysis.ClinicoEconomics and outcomes research : CEOR · 2025Article
- Real-World Patterns and Economic Burden Associated With Treatment Failure With Advanced Therapies in Patients With Moderate-to-Severe Ulcerative Colitis.Crohn's & colitis 360 · 2024Article
- Dose Escalation of Biologics in Biologic-Naïve Patients With Ulcerative Colitis: Outcomes From the ODESSA-UC Study.Crohn's & colitis 360 · 2023Article
- Systematic Literature Review of Real-World Evidence on Dose Escalation and Treatment Switching in Ulcerative Colitis.ClinicoEconomics and outcomes research : CEOR · 2023Review
- Retrospective Database Analysis: Dose Escalation and Adherence in Patients Initiating Biologics for Ulcerative Colitis.Digestive diseases (Basel, Switzerland) · 2022Article
- Frequency and Effectiveness of Empirical Anti-TNF Dose Intensification in Inflammatory Bowel Disease: Systematic Review with Meta-Analysis.Journal of clinical medicine · 2021Review
- Optimizing biologic therapy in inflammatory bowel disease: a Delphi consensus in the United Arab Emirates.Therapeutic advances in gastroenterology · 2021Article
- Treatment persistence and colectomy-free outcomes in patients with ulcerative colitis receiving golimumab or adalimumab: a UK experience.BMJ open gastroenterology · 2020Article
- Dose Escalation Assessment Among Targeted Immunomodulators in the Management of Inflammatory Bowel Disease.Journal of managed care & specialty pharmacy · 2020Article
- Maneuvering Clinical Pathways for Ulcerative Colitis.Current gastroenterology reports · 2019Review
- Costs of dose escalation among ulcerative colitis patients treated with adalimumab in Germany.The European journal of health economics : HEPAC : health economics in prevention and care · 2019Article
- Golimumab: early experience and medium-term outcomes from two UK tertiary IBD centres.Frontline gastroenterology · 2018Article
- Adalimumab Maintenance Treatment in Ulcerative Colitis: Outcomes by Prior Anti-TNF Use and Efficacy of Dose Escalation.Digestive diseases and sciences · 2017Observational
- Treating iron deficiency in patients with gastrointestinal disease: Risk of re-attendance in secondary care.PloS one · 2017Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo describe the real-world use of adalimumab for maintenance treatment of ulcerative colitis (UC) and associated healthcare costs in English hospitals.
designRetrospective cohort study.
settingAnalysis of NHS Hospital Episode Statistics linked with pharmacy dispensing data in English hospitals. PATIENTS: Adult UC patients receiving ≥240mg during adalimumab treatment induction, subsequently maintained on adalimumab. OUTCOMES: Frequency and pattern of adalimumab use and dose escalation during maintenance treatment and associated healthcare costs (prescriptions and hospital visits).
results191 UC patients completed adalimumab treatment induction. 83 (43.46%) dose escalated during maintenance treatment by ≥100% (equivalent to weekly dosing) (median time to dose escalation: 139 days). 56 patients (67.47%) subsequently de-escalated by ≥50% (median time to dose de-escalation: 21 days). Mean all-cause healthcare costs for all patients ≤12 months of index were £13,892. Dose escalators incurred greater mean healthcare costs than non-escalators ≤12 months of index (£14,596 vs. £13,351). Prescriptions accounted for 96.49% of UC-related healthcare costs (£11,090 of £11,494 in all patients).
conclusionsWithin the cohort, 43.46% of UC patients escalated their adalimumab dose by ≥100% and incurred greater costs than non-escalators. The apparent underestimation of adalimumab dose escalation in previous studies may have resulted in underestimated costs in healthcare systems.
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