New tests to help guide treatment for people with Crohn’s disease require further research before they can be recommended for routine use in the NHS, according to NICE.
As part of new guidance released by the organisation on the digestive condition, NICE have recommended that clinicians should collect information on their use in people whose Crohn’s disease loses response to TNF-alpha inhibitors, antibodies that can be beneficial to people with the condition.
‘Tests that can accurately measure levels of TNF-alpha inhibitors and antibodies to them could enable people with Crohn’s disease to receive treatment that’s better tailored to their needs to allow treatment optimisation with fewer side effects,’ Professor Carole Longson, director of the NICE Health Technology Evaluation Centre.
According to NICE, tailoring TNF-alpha inhibitor treatment to the patient can pose problems. This is because decisions are based on clinical judgement and ‘trial and error’. This can mean that people whose disease responds well to treatment with a TNF-alpha inhibitor may continue to receive the same level of treatment, despite a decrease in dose or withdrawing it altogether may be possible without any detrimental impact on the patient’s health. Continuing treatment may lead to patients unnecessarily experiencing side-effects of the treatment.
‘The tests reviewed in this guidance show real promise,’ added Professor Longson. ‘But the committee was concerned that, because of the complexities in interpreting test results there is a risk they could be incorrectly used by clinicians without specialist knowledge of immunoassay analysis. The committee therefore concluded that in people with Crohn’s disease whose disease loses response to TNF alpha inhibitors, for the time being, these tests should be used only in those laboratories that have specialist expertise in immunoassay analysis.’