Toxicology and Diseases Group (TDG), Pharmaceutical Sciences Research Center (PSRC), the Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran.
Department of Toxicology and Pharmacology, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
Expert Rev Clin Pharmacol. 2021 Jul;14(7):865-888. doi: 10.1080/17512433.2021.1925108. Epub 2021 Jul 21.
: Due to the high cost, low effectiveness, and adverse effects plus the life-long nature of inflammatory bowel disease (IBD), and misconception on safety, efficacy, and cost-effectiveness of complementary and alternative medicine (CAM), the market demand for CAM has risen over the past decades. A critical review of patients' and physicians' attitudes, market drivers, economic aspects, regulatory roles, and regional distribution is lacking.: Through relevant databases, the existing English language literature concerning the association of CAM use with IBD was collected over the past two decades. Data was then analyzed, comprehensively summarized in tables/figures, and justified concerning administrative, organizational, regional, economic, and regulatory perspectives.: Although CAM utilization is more prevalent among younger, female, and high-educated IBD patients, issues concerning weak study designs, limited-time period/regional distribution of recent surveys, and lack of economic evaluations on CAM make it entirely unfeasible to draw a firm conclusion. Regulators are lagging in meeting the dire need of IBD patients, especially the elderly. Lack of legislation regarding registration, sales monitoring, licensing, insurance coverage, efficacy/safety assessments, post-marketing surveillance, quality assurance, and reference pricing alongside the limited support for CAM research are the main matters that should be urgently addressed.
: 由于炎症性肠病(IBD)的高成本、低疗效和不良反应,以及对补充和替代医学(CAM)的安全性、疗效和成本效益的误解,过去几十年来,CAM 的市场需求不断上升。目前缺乏对患者和医生的态度、市场驱动因素、经济方面、监管作用和区域分布的批判性审查。: 通过相关数据库,收集了过去二十年来有关 CAM 使用与 IBD 相关性的现有英文文献。然后对数据进行分析,以表格/图形的形式进行全面总结,并从行政、组织、区域、经济和监管角度进行论证。: 尽管 CAM 的使用率在年轻、女性和高学历的 IBD 患者中更为普遍,但研究设计薄弱、近期调查的时间/区域分布有限以及缺乏 CAM 经济评估等问题使得我们无法得出确凿的结论。监管机构在满足 IBD 患者的迫切需求方面落后了,尤其是老年人。缺乏关于注册、销售监测、许可、保险覆盖、疗效/安全性评估、上市后监测、质量保证和参考定价的立法,以及对 CAM 研究的支持有限,这些都是亟待解决的主要问题。