Tu1171 Reduced Recurrence Rates in Crohn's Disease but Not in Ulcerative Colitis in the Era of Immunomodulators and Biological Therapy: A 7-Year Population-Based Follow-Up Study of Inflammatory Bowel Disease

Summary Background: There is an impression mostly from specialty clinics that patients with inflammatory bowel disease (IBD) have an increased risk of venous thromboembolic disorders. Our aim was to determine the incidence of deep venous thrombosis (DVT) and pulmonary embolism (PE) from a population-based database of IBD patients and, to compare the incidence rates to that of an age, gender and geographically matched population control group. Methods: IBD patients identified from the administrative claims data of the universal provincial insurance plan of Manitoba were matched 1:10 to randomly selected members of the general population without IBD by year, age, gender, and postal area of residence using Manitoba Health’s population registry. The incidence of hospitalization for DVT and PE was calculated from hospital discharge abstracts using ICD-9-CM codes 451.1, 453.x for DVT and 415.1x for PE. Rates were calculated based on person-years of follow-up for 1984-1997. Comparisons to the population cohort yielded age-adjusted incidence rate ratios (IRR). Rates were calculated based on person-years of follow-up (Crohn’s disease = 21,340, ulcerative colitis = 19,665) for 1984-1997. Results: In Crohn’s disease the incidence rate of DVT was 31.4/10,000 person-years and of PE was 10.3/10,000 person-years. In ulcerative colitis the incidence rates were 30.0/10,000 person-years for DVT and 19.8/10,000 person-years for PE. The IRR was 4.7 (95% CI, 3.5-6.3) for DVT and 2.9 (1.8-4.7) for PE in Crohn’s disease and 2.8 (2.1-3.7) for DVT and 3.6 (2.5-5.2) for PE, in ulcerative colitis. There were no gender differences for IRR. The highest rates of DVT and PE were seen among patients over 60 years old; however the highest IRR for these events were among patients less than 40 years. Conclusion: IBD patients have a threefold increased risk of developing DVT or PE.

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Bone mineral density in patients with inflammatory bowel disease: A population‐based prospective two‐year follow‐up study

Scandinavian Journal of Gastroenterology ◽

10.1080/00365520310007873 ◽

2004 ◽

Vol 39 (2) ◽

pp. 145-153 ◽

Cited By ~ 59

Author(s):

J. Jahnsen ◽

J. A. Falch ◽

P. Mowinckel ◽

E. Aadland

Keyword(s):

Bone Mineral Density ◽

Inflammatory Bowel Disease ◽

Bone Mineral ◽

Bowel Disease ◽

Population Based ◽

Mineral Density ◽

Follow Up Study ◽

Inflammatory Bowel

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Intestinal Ultrasound in Inflammatory Bowel Disease: A Valuable and Increasingly Important Tool

GE Portuguese Journal of Gastroenterology ◽

10.1159/000520212 ◽

2021 ◽

pp. 1-17

Author(s):

Catarina Frias-Gomes ◽

Joana Torres ◽

Carolina Palmela

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Disease Activity ◽

Bowel Disease ◽

Response To Therapy ◽

Inflammatory Bowel

Background: Intestinal ultrasound is emerging as a non-invasive tool for monitoring disease activity in inflammatory bowel disease patients due to its low cost, excellent safety profile, and availability. Herein, we comprehensively review the role of intestinal ultrasound in the management of these patients. Summary: Intestinal ultrasound has a good accuracy in the diagnosis of Crohn’s disease, as well as in the assessment of disease activity, extent, and evaluating disease-related complications, namely strictures, fistulae, and abscesses. Even though not fully validated, several scores have been developed to assess disease activity using ultrasound. Importantly, intestinal ultrasound can also be used to assess response to treatment. Changes in ultrasonographic parameters are observed as early as 4 weeks after treatment initiation and persist during short- and long-term follow-up. Additionally, Crohn’s disease patients with no ultrasound improvement seem to be at a higher risk of therapy intensification, need for steroids, hospitalisation, or even surgery. Similarly to Crohn’s disease, intestinal ultrasound has a good performance in the diagnosis, activity, and disease extent assessment in ulcerative colitis patients. In fact, in patients with severe acute colitis, higher bowel wall thickness at admission is associated with the need for salvage therapy and the absence of a significant decrease in this parameter may predict the need for colectomy. Short-term data also evidence the role of intestinal ultrasound in evaluating therapy response, with ultrasound changes observed after 2 weeks of treatment and significant improvement after 12 weeks of follow-up in ulcerative colitis. Key Messages: Intestinal ultrasound is a valuable tool to assess disease activity and complications, and to monitor response to therapy. Even though longer prospective data are warranted, intestinal ultrasound may lead to a change in the paradigm of inflammatory bowel disease management as it can be used in a point-of-care setting, enabling earlier intervention if needed.

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Disease outcome of inflammatory bowel disease patients: General outline of a Europe-wide population-based 10-year clinical follow-up study

Scandinavian Journal of Gastroenterology ◽

10.1080/00365520600664250 ◽

2006 ◽

Vol 41 (sup243) ◽

pp. 46-54 ◽

Cited By ~ 49

Author(s):

Frank L. Wolters ◽

Maurice G. Russel ◽

Jildou Sijbrandij ◽

Leo J. Schouten ◽

Selwyn Odes ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Population Based ◽

Disease Outcome ◽

General Outline ◽

Follow Up Study ◽

Inflammatory Bowel ◽

Wide Population

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Cancer in inflammatory bowel disease 15years after diagnosis in a population-based European Collaborative follow-up study

Journal of Crohn s and Colitis ◽

10.1016/j.crohns.2011.04.013 ◽

2011 ◽

Vol 5 (5) ◽

pp. 430-442 ◽

Cited By ~ 26

Author(s):

Konstantinos H. Katsanos ◽

Athina Tatsioni ◽

Natalia Pedersen ◽

Mary Shuhaibar ◽

Vicent Hernandez Ramirez ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Population Based ◽

Follow Up Study ◽

Inflammatory Bowel

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Real-world Effectiveness and Safety of Vedolizumab for the Treatment of Inflammatory Bowel Disease: The Scottish Vedolizumab Cohort

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz042 ◽

2019 ◽

Vol 13 (9) ◽

pp. 1111-1120 ◽

Cited By ~ 9

Author(s):

N Plevris ◽

C S Chuah ◽

R M Allen ◽

I D Arnott ◽

P N Brennan ◽

...

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Real World ◽

Bowel Disease ◽

Clinical Remission ◽

Mucosal Healing ◽

Inflammatory Bowel

Abstract Background & Aims Vedolizumab is an anti-a4b7 monoclonal antibody that is licensed for the treatment of moderate to severe Crohn’s disease and ulcerative colitis. The aims of this study were to establish the real-world effectiveness and safety of vedolizumab for the treatment of inflammatory bowel disease. Methods This was a retrospective study involving seven NHS health boards in Scotland between June 2015 and November 2017. Inclusion criteria included: a diagnosis of ulcerative colitis or Crohn’s disease with objective evidence of active inflammation at baseline (Harvey–Bradshaw Index[HBI] ≥5/Partial Mayo ≥2 plus C-reactive protein [CRP] >5 mg/L or faecal calprotectin ≥250 µg/g or inflammation on endoscopy/magnetic resonance imaging [MRI]); completion of induction; and at least one clinical follow-up by 12 months. Kaplan–Meier survival analysis was used to establish 12-month cumulative rates of clinical remission, mucosal healing, and deep remission [clinical remission plus mucosal healing]. Rates of serious adverse events were described quantitatively. Results Our cohort consisted of 180 patients with ulcerative colitis and 260 with Crohn’s disease. Combined median follow-up was 52 weeks (interquartile range [IQR] 26–52 weeks). In ulcerative colitis, 12-month cumulative rates of clinical remission, mucosal healing, and deep remission were 57.4%, 47.3%, and 38.5%, respectively. In Crohn’s disease, 12-month cumulative rates of clinical remission, mucosal healing, and deep remission were 58.4%, 38.9%, and 28.3% respectively. The serious adverse event rate was 15.6 per 100 patient-years of follow-up. Conclusions Vedolizumab is a safe and effective treatment for achieving both clinical remission and mucosal healing in ulcerative colitis and Crohn’s disease.

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Women’s earnings are more affected by inflammatory bowel disease than men’s: a register-based Swedish cohort study

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjaa238 ◽

2020 ◽

Author(s):

Åsa H Everhov ◽

Gustaf Bruze ◽

Jonas Söderling ◽

Johan Askling ◽

Jonas Halfvarson ◽

...

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Bowel Disease ◽

Disposable Income ◽

Inflammatory Bowel ◽

The Individual ◽

Annual Earnings

Abstract Background/Aim Patients with inflammatory bowel disease (IBD) have more work disability than the general population. We aimed to estimate the monetary cost of IBD for the individual through assessment of earnings in relation to diagnosis. Methods Through linkage of national registers we identified patients aged 30-55 years at first IBD diagnosis in Sweden 2002-2011, and same-sex IBD-free siblings. We estimated taxable earnings and disposable income from 5 years before to 5 years after diagnosis. Results The 5,961 patients (27% Crohn’s disease, 68% ulcerative colitis, 4.3% IBD unclassified) had similar taxable earnings as their 7,810 siblings until the year of diagnosis, when earnings decreased and remained lower than in siblings during follow-up. The adjusted difference in earnings over the entire 5-year period after diagnosis was -5% (-8,212€; 95%CI: -11,458 to-4,967). The difference was larger in women than in men, and larger in Crohn’s disease than in ulcerative colitis. When stratifying for sex and IBD subtype and comparing earnings during each year of follow-up, the median annual earnings were lower in women with Crohn’s disease and ulcerative colitis than in their sisters during all years of follow-up, whereas the men had similar annual taxable earnings as their brothers. The disposable income was similar between patients and siblings during the investigated time period. Conclusion From the year of diagnosis and at least 5 years onwards, patients with IBD had 5% lower earnings than siblings, mainly explained by differences between women with IBD and their sisters. However, there were no differences in disposable income.

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Inflammatory Bowel Disease in the United States from 1998 to 2005: Has Infliximab Affected Surgical Rates?

The American Surgeon ◽

10.1177/000313480907501025 ◽

2009 ◽

Vol 75 (10) ◽

pp. 976-980 ◽

Cited By ~ 10

Author(s):

Rebecca R. Cannom ◽

Andreas M. Kaiser ◽

Glenn T. Ault ◽

Robert W. Beart ◽

David A. Etzioni

Keyword(s):

United States ◽

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Bowel Disease ◽

Surgical Care ◽

The United States ◽

Population Based ◽

Inflammatory Bowel

The treatment costs for patients in the United States with inflammatory bowel disease (IBD) exceed 1.7 billion dollars/year. Infliximab, an antibody to tumor necrosis factor-α, has been extensively used to treat IBD, with 390,000 IBD patients receiving the drug since its FDA approval in 1998. We sought to determine the impact of infliximab on population-based rates of hospitalizations and surgical care for patients with IBD in the United States. We used data from the Nationwide Inpatient Sample to analyze patterns of hospital-based treatment provided to patients with IBD between 1998 and 2005. Data from this analysis were combined with census data to calculate trends in population-based rates of treatment. Overall rates of hospitalization for patients with Crohn's disease and ulcerative colitis increased significantly between 1998 and 2005 (5.1%/year and 3.4%/year respectively, P < 0.001 for each). During the same time period there were no changes in the overall rates of surgical care. The expanding use of infliximab has not significantly impacted the use of surgical procedures for patients with either ulcerative colitis or Crohn's disease, and rates of nonsurgical hospitalizations have actually increased. Even in the era of infliximab, surgical care remains a mainstay in the treatment of IBD.

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