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
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