P639 The use of biological therapies in managing patients with IBD in Iraq.
A.K.Q. Al-Rubaye, L. Alrubaiy*
Basra Health Directorate, Family Medicine, Basra, Iraq
Biologic therapies provide a distinct advantage in managing patients with inflammatory bowel disease (IBD). Their use in Iraq is limited due to lack of funding and unstable infrastructure in the health system. The present study aimed to explore the use of biologics therapies used in Iraq for managing patients with IBD.
An online survey with 20 questions relating to prescribing biologics therapies in managing patients with IBD was sent to 35 gastroenterology departmental leads in all regional centres in Iraq managing patients with IBD.
Thirty responces (86%) were received; 80% of respondents were from University Teaching Hospitals, 20% worked in district general hospitals or Private Hospitals. Patients with IBD served ranged from 20 to 500 patients with IBD. All gastroenterologists were aware of the biologics therapies in IBD but only 10% had access to infliximab. Adalimumab was not routinely used. Patients buy infliximab privately as it is not available free in most public hospitals. No agreed IBD management standards exist on a national level. Access to modern endoscopes and biochemical blood markers of inflammation to monitor IBD was acceptable. Active or history of tuberculosis is the commonest contraindication to start biologics therapies. Written information about biologics and IBD is limited and the practice of informed consent falls short of UK standards. There is no national database to record and monitor patients with IBD having biologics treatment. Around 85% reported willingness to use biologics treatment if available in Iraq.
This is the first study of its kind to explore the use of biologics in Iraq. The study identified gaps in the access and use of biologics therapies in Iraq. Future clinical cohort studies are warranted to examine the long-term efficacy and safety of biologics therapies in Iraq.