Guide to Discussing the Risks of Immunomodulator and Anti-TNF Therapy with Inflammatory Bowel Disease Patients

The risks of treatment associated with immunomodulators and biologic therapy for inflammatory bowel disease (IBD) are of concern to both patients and physicians. It is a complicated matter as the actual risks are uncertain, and how these risks apply to individual patients unknown. Patients appear to have misperceptions regarding the risks and benefits of IBD therapy, but when asked how much risk they are willing to take, patients will accept more risk than has been reported in the literature for these medications. When communicating risk information to patients, it is important to acknowledge the uncertainty of the data, present the data as an absolute risk, and discuss risk in the context of the risk of their disease and everyday life. For patients to make an informed and preference based decision, physicians must develop accurate and clear methods of describing the balance of risks versus benefits of treatment.