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. 2025 Aug 18:18:17562848251360907.
doi: 10.1177/17562848251360907. eCollection 2025.

Defining partial response in inflammatory bowel disease: a Delphi consensus and economic evaluation

Iago Rodríguez-Lago  1   2   3 , Luis Menchén  4   5 , José Germán Sánchez-Hernández  6 , Jordi Guardiola  7 , Vicente Merino-Bohórquez  8   9 , Beatriz Garcillán  10 , Elia Moreno-Cubero  10 , Eugenia Vispo  10 , Eugeni Domènech  11
Affiliations

Defining partial response in inflammatory bowel disease: a Delphi consensus and economic evaluation

Iago Rodríguez-Lago et al. Therap Adv Gastroenterol. .

Abstract

Background: Therapeutic goals in inflammatory bowel disease (IBD) are constantly evolving due to novel medical options and diagnostic tools, yet unmet clinical needs persist.

Objectives: We aimed to establish a consensus definition for partial responders in clinical practice, considered as patients failing to meet defined objectives within the desired time frame.

Design: A two-round Delphi consultation was held with IBD-specialized gastroenterologists.

Methods: The 22-item questionnaire covered four clinical scenarios: (1) moderate ulcerative colitis (UC); (2) acute severe UC; (3) luminal Crohn's disease (CD); and (4) perianal CD. Consensus was defined when ⩾70% of panellists agreed with a statement, rated using a 7-point Likert scale. We also analysed the associated annual costs for partial responders and patients in remission according to the agreed long-term definitions, based on a literature review and the experience of the scientific committee. Medication costs were excluded from the analysis.

Results: Sixty Spanish gastroenterologists with extensive experience in IBD management participated in the consultation. Consensus was achieved on partial response definitions with different criteria over time, including clinical scores, biomarkers and imaging or endoscopic examinations. The annual cost for partial responders and patients in remission was estimated at €2570.40 and €820.20 for UC, €1607.30 and €718.0 for luminal CD and €2886.70 and €888.80 for perianal CD, respectively.

Conclusion: The concept of partial responders has been defined in four clinical scenarios. Patients achieving prolonged remission could provide 55%-70% savings in non-pharmacological resource use and associated costs. Our study could help healthcare professionals in decision-making, ultimately improving patient care.

Keywords: IBD; healthcare costs; response to therapy.

Plain language summary

Delphi questionnaire and cost analysis in inflammatory bowel disease Treatment goals for inflammatory bowel diseases (IBD), like ulcerative colitis and Crohn’s disease, are changing because of new treatments and better ways to diagnose these conditions. However, there are still some unmet needs in patient care. The goal of this study was to define the term “partial responders,” which refers to patients who don’t fully meet treatment goals within the expected time. To do this, 60 doctors who specialize in IBD in Spain participated in a survey. The survey included 22 questions about four situations: moderate ulcerative colitis, severe ulcerative colitis, Crohn’s disease in the intestines, and Crohn’s disease around the anus. The doctors agreed on what it means to be a “partial responder” when at least 70% of them gave the same answer. The study also looked at the yearly costs for patients in remission and partial responders, based on existing research and expert opinions. The results showed that doctors agreed on how to define partial responders using things like clinical scores, blood tests, and imaging exams. The study estimated the yearly costs for partial responders and patients in remission. For ulcerative colitis, it was €2,570.40 for partial responders and €820.20 for those in remission. For Crohn’s disease in the intestines, it was €1,607.30 for partial responders and €718.0 for those in remission. For Crohn’s disease around the anus, it was €2,886.70 for partial responders and €888.80 for those in remission. The study concluded that the idea of “partial responders” was clearly defined in these four situations. It also showed that patients in long-term remission could save 55%–70% on non-medical costs. This research can help doctors make better decisions and improve patient care.

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Figures

A flowchart outlining the Delphi consensus process methodology.
Figure 1.
Flowchart of the methodological protocol for the Delphi consensus.
difference in visit or procedure costs between patients with moderate ulcers and those with moderate Crohns and partial relapsers in their treatment options
Figure 2.
Difference in associated costs between patients in remission and partial responders. CD, Crohn’s disease; UC, ulcerative colitis.
See this image and copyright information in PMC

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