scholarly journals P798 Societal costs attributable to Crohn’s disease and ulcerative colitis within the first 5 years after diagnosis: –a Danish Nationwide Cost-of-Illness Study 2003–2015

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S627-S627
Author(s):  
S ALULIS ◽  
K Vadstrup ◽  
A Borsi ◽  
S Elkjær Stallknecht ◽  
J Olsen ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
General Population ◽  
Hospital Admission ◽  
Cost Of Illness ◽  
Control Group ◽  
First Year ◽  
Production Loss ◽  
Societal Costs

Abstract Background There is little information on cost-of-illness among patients diagnosed with Crohn’s disease (CD) and ulcerative colitis (UC) in Denmark. The objective of this study was to estimate the average 5-year societal costs attributable to CD or UC including costs related to health care, prescription medicine, home care, and production loss. Methods Incident patients with CD or UC were identified in the National Patient Registry and matched with a non-IBD control from the general population on age and sex. Attributable costs were estimated applying a difference-in-difference approach, where the total costs among individuals in the control group were subtracted from the total costs among patients. Information on primary and secondary healthcare services were obtained from the National Health Insurance Service Registry. Results CD and UC incidence was approximately 14 and 31 per 100,000 persons-years, respectively. Average attributable costs were highest the first year after diagnosis, with costs equalling €12,919 per CD patient and €6,501 per UC patient. Hospital admission costs accounted for 36% in the CD population and 31% in the UC population, the first year after diagnosis. Production loss exceeded all other costs the third year after diagnosis. Conclusion We found that the societal costs attributable to incident CD and UC patients are substantial compared with the general population, primarily consisting of hospital admission costs and production loss. Appropriate treatment at the right time may be beneficial from a societal perspective.

scholarly journals Cost Burden of Crohn’s Disease and Ulcerative Colitis in the 10-Year Period Before Diagnosis—A Danish Register-Based Study From 2003–2015

2019 ◽  
Vol 26 (9) ◽  
pp. 1377-1382 ◽  
Author(s):  
Kasper Vadstrup ◽  
Sarah Alulis ◽  
Andras Borsi ◽  
Nina Gustafsson ◽  
Agnete Nielsen ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
General Population ◽  
Health Care Services ◽  
Productivity Loss ◽  
Diagnostic Delay ◽  
Home Care Services ◽  
Societal Costs ◽  
Care Services

Abstract Background The diagnostic delay in inflammatory bowel disease (IBD) is well known, yet the costs associated with diagnoses before IBD diagnosis have not yet been reported. This study explored societal costs and disease diagnoses 10 years before Crohn’s disease (CD) and ulcerative colitis (UC) diagnosis in Denmark. Methods This national register study included patients diagnosed between 2003 and 2015 identified in the Danish National Patient Registry (NPR) and controls who were individually matched on age and sex from the general population. Societal costs included health care services, prescription medicine, home care services, and labor productivity loss. Prediagnostic hospital contact occurring before CD or UC diagnosis was identified using the NPR. Average annual costs per individual were calculated before the patient’s first CD or UC diagnosis. A 1-sample t test was then applied to determine significance in differences between cases and controls. Results Among CD (n = 9019) and UC patients (n = 20,913) the average societal costs were higher throughout the entire 10-year period before the diagnosis date compared with the general population. The difference increased over time and equaled €404 for CD patients and €516 for UC patients 10 years before diagnosis and €3377 and €2960, respectively, in the year before diagnosis. Crohn’s disease and UC patients had significantly more diagnoses before their CD and UC diagnosis compared with the general population. Conclusions Compared with the general population, the societal costs and number of additional diagnoses among CD and UC patients were substantially higher in the 10-year period before diagnosis.

scholarly journals Risk and outcomes of coronavirus disease (COVID-19) in patients with inflammatory bowel disease: a systematic review and meta-analysis

2020 ◽  
pp. 205064062097260
Author(s):  
Anupam Kumar Singh ◽  
Anuraag Jena ◽  
Praveen Kumar-M ◽  
Vishal Sharma ◽  
Shaji Sebastian
Keyword(s):  
Ulcerative Colitis ◽  
Intensive Care Unit ◽  
Inflammatory Bowel Disease ◽  
Intensive Care ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
General Population ◽  
Bowel Disease ◽  
Intensive Care Unit Care ◽  
Inflammatory Bowel

Background The risk of severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) infection and clinical outcomes of coronavirus disease (COVID-19) in inflammatory bowel disease are unclear. Methods We searched PubMed and Embase with the keywords: inflammatory bowel disease, Crohn’s disease, ulcerative colitis and COVID-19, novel coronavirus and SARS-CoV-2. We included studies reporting the frequency of COVID-19 infection and outcomes (hospitalisation, need for intensive care unit care and mortality) in patients with inflammatory bowel disease. We estimated the pooled incidence of COVID-19 in inflammatory bowel disease and comparative risk vis-a-vis the general population. We also estimated the pooled frequency of outcomes and compared them in patients who received and did not receive drugs for inflammatory bowel disease. Results Twenty-four studies were included. The pooled incidence rate of COVID-19 per 1000 patients of inflammatory bowel disease and the general population were 4.02 (95% confidence interval (CI) 1.44–11.17) and 6.59 (3.25–13.35), respectively, with no increase in relative risk (0.47, 0.18–1.26) in inflammatory bowel disease. The relative risk of the acquisition of COVID-19 was not different between ulcerative colitis and Crohn’s disease (1.03, 0.62–1.71). The pooled proportion of COVID-19-positive inflammatory bowel disease patients requiring hospitalisation and intensive care unit care was 27.29% and 5.33% while pooled mortality was 4.27%. The risk of adverse outcomes was higher in ulcerative colitis compared to Crohn’s disease. The relative risks of hospitalisation, intensive care unit admission and mortality were lower for patients on biological agents (0.34, 0.19–0.61; 0.49, 0.33–0.72 and 0.22, 0.13–0.38, respectively) but higher with steroids (1.99, 1.64–2.40; 3.41, 2.28–5.11 and 2.70, 1.61–4.55) or 5-aminosalicylate (1.59, 1.39–1.82; 2.38, 1.26–4.48 and 2.62, 1.67–4.11) use. Conclusion SARS-CoV-2 infection risk in patients with inflammatory bowel disease is comparable to the general population. Outcomes of COVID-19-positive inflammatory bowel disease patients are worse in ulcerative colitis, those on steroids or 5-aminosalicylates but outcomes are better with biological agents.

P125 COMPLICATIONS FOLLOWING OUTPATIENT COLONOSCOPY IN INFLAMMATORY BOWEL DISEASE (IBD) PATIENTS

2020 ◽  
Vol 26 (Supplement_1) ◽  
pp. S24-S24
Author(s):  
Daniel Chu ◽  
Po-Hung Chen ◽  
Steven Brant ◽  
Steven Miller ◽  
Natasha Turner ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
General Population ◽  
Bowel Disease ◽  
Intestinal Perforation ◽  
The United States ◽  
Icd 10 ◽  
Inflammatory Bowel

Abstract Inflammatory Bowel Disease (IBD) patients have frequent complications after surgical procedures. Inflammation, immunosuppression and other factors that are more common in Crohn’s disease (CD) and ulcerative colitis (UC) may play a role in increasing their complication risk profile. IBD patients also undergo colonoscopy procedures more frequently than the general population. We aimed to identify risks of complications during or within 7 days of colonoscopy in IBD patients. Methods: Colonoscopy procedures performed between January 2016 through March 2019 in an outpatient setting (hospital or ambulatory surgical center) were identified from the United States Medicare fee-for-service claims. All Medicare beneficiaries were eligible. Colonoscopy was identified using the Healthcare Common Procedure Coding System (HCPCS) codes (‘45378’ through ‘45393’ and ‘45398’). A patient was considered to have Crohn’s disease (CD) if ICD-10-CM code K50.x was recorded; Ulcerative Colitis (UC) if ICD-10-CM code K51.x was recorded; and IBD if either was recorded on the date of the procedure. Complications recorded during the procedure included intestinal perforation (K63.1), gastrointestinal hemorrhage (K92.2), and “other post-procedural complications of the digestive system” (K91), including, but not limited to, post-gastrectomy syndrome, malabsorption, and intestinal obstruction. We examined these complications in procedures performed on IBD patients compared to the general population using logistic regression. We accounted for age, sex, race, year of colonoscopy, comorbidity score, and procedure discontinuation (identified by HCPCS modifier) in the analysis. A random effect for patient was included in the model to account for multiple procedures performed in the same patient during the study period, restricting patients from contributing multiple procedures. Results: There were 3,181,759 eligible procedures. There were 26,583 (0.84%) colonoscopy procedures in CD patients and 50,708 (1.59%) in UC patients. After accounting for other risk factors, CD and UC were more likely to have intestinal perforation than the non-IBD population (CD OR=2.7, 95% CI: 1.1–6.5; UC=OR 1.9, 95% CI 0.9–4.1), with CD having a statistically significant increase. Women were at greater risk for perforations (OR=1.3; 95% CI: 1.0–1.7). Conversely, IBD patients were less likely than non-IBD patients to have a complication recorded as “other” (CD OR=0.5; 95% CI: 0.2–0.9; UC OR=0.5; 95% CI:0.3–0.8). Older age at colonoscopy (OR=1.02, 95% CI 1.01–1.03), six or more comorbidities (OR=1.9, 95% CI: 1.5–2.3) and procedure discontinuation (OR=2.0, 95% CI 1.2–3.4) were associated with complications regardless of IBD status. Conclusion: IBD was associated with higher risk of perforation, and lower risk of other postprocedural complications in outpatient colonoscopy procedures.

Specific quality of life factors in patients with inflammatory bowel disease

2012 ◽  
Vol 153 (38) ◽  
pp. 1511-1519 ◽  
Author(s):  
Beáta Nagy ◽  
Réka Laczkóné Majer
Keyword(s):  
Quality Of Life ◽  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Content Analysis ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Control Group ◽  
Inflammatory Bowel

Introduction: Inflammatory bowel disease is a chronic disease with a fluctuating course and unknown origin. Its two major forms are Crohn’s disease and ulcerative colitis. Objective: The authors attempted to analyse the quality of life of patients with inflammatory bowel disease as compared to healthy persons and patients with asthma in order to identify specific factors which most significantly affect the quality of life of these patients. Method: 269 subjects participated in the study (control group, 115 subjects; Crohn’s disease, 67 patients; ulcerative colitis, 25 patients; asthma, 62 patients). The following methods were used: WHO-5, IIRS, SIBDQ and AQLQ(S) questionnaires and content analysis. Results: Patients with inflammatory bowel disease had the worst quality of life with respect to both subjective well-being and burden of disease. The results obtained from questionnaires developed for the analysis of quality of life indicated that extraintestinal symptoms and emotional problems are the major factors which interfere with the quality of life of patients with inflammatory bowel disease. These findings were confirmed by content analysis of interviews with patients. Conclusions: The authors recommend that more attention should be paid to improving the quality of life of patients with inflammatory bowel disease and helping them to live with the illness, especially at the level of interpersonal relations. Orv. Hetil., 2012, 153, 1511–1519.

scholarly journals Imbalance of Controlled Death in Peripheral Blood Lymphocytes in Crohn’s Disease and Ulcerative Colitis

Medicina ◽  
2019 ◽  
Vol 55 (6) ◽  
pp. 231 ◽  
Author(s):  
Ewa Dudzińska ◽  
Kinga Szymona ◽  
Paulina Gil-Kulik ◽  
Piotr Chomik ◽  
Małgorzata Świstowska ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Peripheral Blood ◽  
Healthy Subjects ◽  
Mrna Level ◽  
Peripheral Blood Lymphocytes ◽  
Simultaneous Increase ◽  
Control Group ◽  
Blood Lymphocytes

Background and objectives: Inflammatory bowel disease (IBD) mainly includes Crohn’s disease (CD) and ulcerative colitis (UC). Both conditions are associated with an exacerbated intestinal immune response to harmless stimuli, leading to upregulation of pro-inflammatory mediators. Materials and Methods: The subjects of the study were 55 patients with IBD. The control group consisted of 35 healthy subjects. The researched material consisted of peripheral blood lymphocytes collected from the subjects. Expression of the genes BAX, BCL2, CASP3 and CASP9 was assessed at the mRNA level in the peripheral blood lymphocytes of patients with ulcerative colitis and Crohn’s disease relative to the healthy subjects. The expression of the genes was determined by rtPCR using TaqMan probes specific for these genes. Results: The group of patients diagnosed with CD had statistically significantly higher expression of the genes BAX (p = 0.012), BCL2 (p = 0.022), CASP3 (p = 0.003) and CASP9 (p = 0.029) than healthy subjects. Expression of BAX, BCL2, CASP3 and CASP9 in UC patients in the active phase of the disease was significantly lower than in patients in remission: BAX (p = 0.001), BCL2 (p = 0.038) and CASP9 (p = 0.007). In patients with UC, the BAX/BCL2 ratio was significantly correlated (r = 0.473) with the duration of the disease. In the group of CD patients treated biologically, a significantly lower BAX/BCL2 ratio was demonstrated than in patients that were not biologically treated. Conclusions: Our research has shown a simultaneous increase in the expression of the anti-apoptotic BCL2 gene and the proapoptotic BAX gene, which suggests the dysregulation of apoptosis mechanisms in IBD. Significantly higher expression of BAX and BCL2 in UC patients in remission as compared to CD may suggest differences in these diseases in terms of prognosis and treatment. Our results may suggest that an underlying imbalance in factors controlling apoptosis in peripheral blood lymphocytes may be the response of the immune system to inflammation of the intestinal mucosa. Modulation of apoptosis may become an important therapeutic mechanism in IBD.

scholarly journals The cost burden of Crohn’s disease and ulcerative colitis depending on biologic treatment status – a Danish register-based study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sarah Alulis ◽  
Kasper Vadstrup ◽  
Jens Olsen ◽  
Tine Rikke Jørgensen ◽  
Niels Qvist ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Healthcare Costs ◽  
Treatment Initiation ◽  
Annual Production ◽  
First Year ◽  
Biologic Treatment ◽  
Production Values ◽  
Average Annual Production

Abstract Background Patients diagnosed with inflammatory bowel disease may be treated with biologics, depending on several medical and non-medical factors. This study investigated healthcare costs and production values of patients treated with biologics. Methods This national register study included patients diagnosed with Crohn’s disease (CD) and ulcerative colitis (UC) between 2003 and 2015, identified in the Danish National Patient Register (DNPR). Average annual healthcare costs and production values were compared for patients receiving biologic treatment or not, and for patients initiating biologic treatment within a year after diagnosis or at a later stage. Cost estimates and production values were based on charges, fees and average gross wages. Results Twenty-six point one percent CD patients and ten point seven percent of UC patients were treated with biologics at some point in the study period. Of these, 46.4 and 45.5 % of patients initiated biologic treatment within the first year after diagnosis. CD and UC patients treated with biologics had higher average annual healthcare costs after diagnosis compared to patients not treated with biologics. CD patients receiving biologics early had lower production values both ten years before and eight years after treatment initiation, compared to patients receiving treatment later. UC patients receiving biologics early had lower average annual production values the first year after treatment initiation compared to UC patients receiving treatment later. Conclusions CD and UC patients receiving biologic treatment had higher average annual healthcare costs and lower average annual production values, compared to patients not receiving biologic treatment. The main healthcare costs drivers were outpatient visit costs and admission costs.

scholarly journals A Regional Survey of Awareness of Inflammatory Bowel Disease among the Saudi Population

2020 ◽  
Author(s):  
Yaser Meeralam ◽  
Adnan Al Zanabgi ◽  
Mosily Mahmoud ◽  
Yusuf Qari ◽  
Mona Al Saedi ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Saudi Arabia ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
General Population ◽  
Bowel Disease ◽  
Average Score ◽  
P Value ◽  
Inflammatory Bowel

Abstract Background: Inflammatory bowel disease (IBD) is common among different age groups worldwide, Including the gulf region. It is categorized into Crohn's disease and Ulcerative colitis. Early diagnosis and treatment of inflammatory bowel disease can improve patients' outcomes and reduce the incidence of complications. However, early diagnosis is highly dependent on patients' awareness of the disease to seek medical advice. This study aims to survey the awareness IBD in the general population of the western region of Saudi Arabia. Methods: A self-administered structured questionnaire was translated into Arabic and distributed to the general public above 16 years old. The questionnaire included questions about Crohn's disease and Ulcerative colitis and their treatment, in addition to the respondents' demographic data. Results: 1304 participants responded to this survey. 29% had not heard or read about Crohn's disease, while 19% of the responders had not heard or read about Ulcerative colitis. The mean awareness level score was 1.72±1.19, with a minimum score of 0 and a maximum score of 3. Females showed a significantly higher average score compared to males (p-value < 0.001). Also, the age group between 31 to 40 had the highest average score (p value=0.002). Moreover, responders, who had a Ph.D., showed significantly higher mean scores than the other educational degrees (p value<0.001). Responders who dealt with Crohn's disease patient or ulcerative colitis patients, showed significantly higher scores than their peers, with p values < 0.001 for bothConclusion: The general population in Saudi Arabia has an unacceptable level of awareness of inflammatory bowel disease. Males, young adults, highly educated individuals who dealt with patients previously had better awareness compared to the rest of the population. National acts are essential to improve public awareness towards the disease.

scholarly journals The use of selected neutrophil protein plasma concentrations in the diagnosis of Crohn’s disease and ulcerative colitis – a preliminary report

2017 ◽  
Vol 71 (1) ◽  
pp. 0-0 ◽  
Author(s):  
Dorota Pawlica-Gosiewska ◽  
Bogdan Solnica ◽  
Katarzyna Gawlik ◽  
Dorota Cibor ◽  
Tomasz Mach ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Plasma Concentrations ◽  
Differential Diagnostics ◽  
Diagnostic Tools ◽  
Control Group ◽  
Clinical Activity ◽  
Leukocyte Elastase ◽  
Diagnostic Characteristics

Background: Difficulties in diagnosis of inflammatory bowel disease (IBD) motivate the search for new diagnostic tools, including laboratory tests. The aim of this study was to evaluate concentrations of the neutrophil (NEU) proteins leukocyte elastase (HLE-α1AT), lactoferrin and calprotectin as potential biomarkers used in the diagnosis and assessment of clinical activity of Crohn’s disease (CD) and ulcerative colitis (UC).Material/Methods: The study included 27 patients with CD, 33 patients with UC and 20 healthy controls. Plasma concentrations of calprotectin, lactoferrin and HLE-α1AT were measured using ELISA.Results: In patients with CD higher concentrations of HLE-α1AT (64.3±43.1 vs. 30.1±7.7 ng/l, P&amp;amp;lt;0.001), calprotectin (151.6±97.8 vs. 69.9±22.1 ng/l, P&amp;amp;lt;0.001) and lactoferrin (243.2±102.0 vs. 129.7±32.7 ng/l, P&amp;amp;lt;0.001) than in the control group were found. In patients with UC higher plasma concentrations of HLE-α1AT (62.0±30.9 vs. 30.1±7.7 ng/l, P&amp;amp;lt;0.001), calprotectin (149.6±72.3 vs. 69.9±22.1 ng/l, P&amp;amp;lt;0.001) and lactoferrin (242.6±107.5 vs 129.7±32.7 ng/l, P&amp;amp;lt;0.001) than in the control group were found. HLE-α1AT/NEU and lactoferrin/NEU ratios in patients with UC were significantly higher compared with patients with CD. Calprotectin (P=0.010) and lactoferrin (P=0.023) levels were higher in patients with the active compared with inactive phase of CD.Conclusions: The diagnostic characteristics of plasma granulocyte protein concentrations indicate the usefulness of these tests in the diagnosis of IBD. Higher HLE-α1AT and lactoferrin/NEU ratios in patients with UC than with CD may suggest the usefulness of these ratios in differential diagnostics. Plasma calprotectin and lactoferrin levels may be useful in CD activity assessment.

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