scholarly journals Real world evidence of the association between medication and life expectancy in elderly inflammatory bowel disease: a population-based cohort study

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
M. Ellen Kuenzig ◽  
Douglas G. Manuel ◽  
Jessy Donelle ◽  
Eric I. Benchimol
Keyword(s):  
Older Adults ◽  
Inflammatory Bowel Disease ◽  
Life Expectancy ◽  
Combination Therapy ◽  
Bowel Disease ◽  
Population Based ◽  
Real World Evidence ◽  
Inflammatory Bowel ◽  
Biologic Monotherapy

Abstract Background Life expectancy in people with inflammatory bowel disease (IBD) has increased but remains shorter than in people without IBD. We describe the life expectancy associated with IBD therapies among the growing number of older adults living with IBD. Methods Older adults (≥ 65 years) with IBD were identified from population-based health administrative data using a validated algorithm. Life expectancy on patients’ 65th birthday, stratified by sex, was calculated using a period life table approach from age- and sex-specific mortality rates among patients receiving immunomodulator monotherapy, biologic monotherapy, combination therapy, mesalamine, systemic steroids, and no therapy. Results Among 28,260 older adults with IBD (239,125 person-years of follow-up), life expectancy at 65 years was longest for patients taking mesalamine (females: 22.1 years, 95% CI 21.8–22.5; males: 19.6 years, 95% CI 19.3–20.0) and shortest for patients taking steroids (females: 11.7 years, 95% CI 11.0–12.4; males 10.3 years, 95% CI 9.7–10.8). Life expectancy was similar for patients receiving immunomodulator monotherapy and biologic monotherapy. Immunomodulator monotherapy was associated with a reduction in life expectancy compared to combination therapy by 5.1 (95% CI 2.3–7.8) in females and 2.8 years (95% CI 0.1–5.5) in males. Conclusions Life expectancy varies across therapies used for IBD, with differences likely arising from a combination of medication effectiveness, safety profiles, disease severity, and comorbid conditions. These considerations should be balanced when deciding on a therapeutic approach for the management of IBD in older adults.

scholarly journals Utility of routinely collected electronic health records data to support effectiveness evaluations in inflammatory bowel disease: a pilot study of tofacitinib

2021 ◽  
Vol 28 (1) ◽  
pp. e100337
Author(s):  
Vivek Ashok Rudrapatna ◽  
Benjamin Scott Glicksberg ◽  
Atul Janardhan Butte
Keyword(s):  
Inflammatory Bowel Disease ◽  
Pilot Study ◽  
Disease Activity ◽  
Real World ◽  
Bowel Disease ◽  
P Value ◽  
Health Records ◽  
Real World Evidence ◽  
Inflammatory Bowel

ObjectivesElectronic health records (EHR) are receiving growing attention from regulators, biopharmaceuticals and payors as a potential source of real-world evidence. However, their suitability for the study of diseases with complex activity measures is unclear. We sought to evaluate the use of EHR data for estimating treatment effectiveness in inflammatory bowel disease (IBD), using tofacitinib as a use case.MethodsRecords from the University of California, San Francisco (6/2012 to 4/2019) were queried to identify tofacitinib-treated IBD patients. Disease activity variables at baseline and follow-up were manually abstracted according to a preregistered protocol. The proportion of patients meeting the endpoints of recent randomised trials in ulcerative colitis (UC) and Crohn’s disease (CD) was assessed.Results86 patients initiated tofacitinib. Baseline characteristics of the real-world and trial cohorts were similar, except for universal failure of tumour necrosis factor inhibitors in the former. 54% (UC) and 62% (CD) of patients had complete capture of disease activity at baseline (month −6 to 0), while only 32% (UC) and 69% (CD) of patients had complete follow-up data (month 2 to 8). Using data imputation, we estimated the proportion achieving the trial primary endpoints as being similar to the published estimates for both UC (16%, p value=0.5) and CD (38%, p-value=0.8).Discussion/ConclusionThis pilot study reproduced trial-based estimates of tofacitinib efficacy despite its use in a different cohort but revealed substantial missingness in routinely collected data. Future work is needed to strengthen EHR data and enable real-world evidence in complex diseases like IBD.

scholarly journals Erratum to “Cancer in inflammatory bowel disease 15years after diagnosis in a population-based European Collaborative follow-up study” [J Crohns Colitis (2011) 5, 430-442]

2012 ◽  
Vol 6 (1) ◽  
pp. 132-133 ◽  
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

scholarly journals Risk of Anxiety and Depression in Patients with Inflammatory Bowel Disease: A Nationwide, Population-Based Study

2019 ◽  
Vol 8 (5) ◽  
pp. 654 ◽  
Author(s):  
Kookhwan Choi ◽  
Jaeyoung Chun ◽  
Kyungdo Han ◽  
Seona Park ◽  
Hosim Soh ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
General Population ◽  
Bowel Disease ◽  
Population Based ◽  
Anxiety And Depression ◽  
Healthcare Insurance ◽  
Inflammatory Bowel ◽  
One Year ◽  
Constant Slope

Background and Aims: Inflammatory bowel disease (IBD) may be associated with anxiety and depression. The aim of this study was to evaluate the incidence of anxiety and depression in patients with IBD compared to the general population. Methods: A nationwide population-based cohort study was conducted using claims data from the National Healthcare Insurance service in Korea. We compared the incidence of anxiety and depression between 15,569 IBD patients and 46,707 non-IBD controls, age and sex matched at a ratio of 1:3. Results: During a mean follow-up of six years, IBD patients experienced significantly more anxiety (12.2% vs. 8.7%; p < 0.001) and depression (8.0% vs. 4.7%; p < 0.001) compared to controls. The curves showing cumulative incidences of anxiety and depression showed a steep rise within one year following a diagnosis of IBD, leading to lines with a constant slope. The hazard ratio (HR) for new onset anxiety following a diagnosis of Crohn’s disease (CD) and ulcerative colitis (UC) was 1.63 and 1.60, respectively, compared to controls (p < 0.001). Compared to controls, the HR for developing depression after a diagnosis of CD and UC was 2.09 and 2.00, respectively (p < 0.001). The risks of anxiety and depression in patients with IBD were higher compared to controls, except in those with diabetes mellitus, hypertension, and dyslipidemia, or who required immunomodulators and biologics within one year of the IBD diagnosis. Conclusions: The risk of anxiety and depression increased after a diagnosis of IBD compared to the general population.

Su1080 Increased Risk of Work Disability in Inflammatory Bowel Disease Patients After Seven Years of Follow-Up - A Population-Based Cohort Study

2015 ◽  
Vol 148 (4) ◽  
pp. S-402
Author(s):  
Marianne K. Vester-Andersen ◽  
Michelle V. Prosberg ◽  
Ida Vind ◽  
Mikael Anderson ◽  
Tine Jess ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Cohort Study ◽  
Bowel Disease ◽  
Work Disability ◽  
Population Based ◽  
Increased Risk ◽  
Inflammatory Bowel

scholarly journals P809 Increase of tuberculosis due to combination therapy in inflammatory bowel disease: a nationwide population-based study in Korea

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S632-S632
Author(s):  
S J Choi ◽  
E S Kim ◽  
J M Lee ◽  
H S Choi ◽  
B Keum ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Combination Therapy ◽  
Tumour Necrosis Factor ◽  
Bowel Disease ◽  
Tumour Necrosis ◽  
Large Population ◽  
Population Data ◽  
Population Based ◽  
Inflammatory Bowel ◽  
Necrosis Factor

Abstract Background Recent researches reported that inflammatory bowel disease (IBD) in Asia has become more prevalent. Since IBD is chronic inflammation disorder and its relapse is frequent, obtaining and maintaining remission is important. As our knowledge on the pathogenesis of IBD deepened, many immunosuppressants and biological agents were introduced and confirmed to be both safe and effective. However, biologics known as anti-tumour necrosis factor (anti-TNF) agents was reported to lose response over time in 23–46% of patients. Therefore, combination therapy adding immunomodulator drug such as azathioprine was introduced and showed better outcome by optimising biologic pharmacokinetics and minimising immunogenicity. Adversely, rates of tuberculosis are increased, but there is no large population data estimating and comparing these risk in combination therapy. Methods We used 2008–2016 data of the South Korean Health Insurance and Review Agency (HIRA), and odd ratio (OR) for tuberculosis in IBD patients who underwent anti-tumour necrosis factor (TNF) agent, azathioprine, or combination therapy. Results Between 2008 and 2016, 47,760 patients were newly diagnosed as IBD, 29,440 as UC and 15,320 as CD. We compared the risk of tuberculosis according to the medication divided into 5 groups; infliximab only, azathioprine only, combination of azathioprine and infliximab, azathioprine monotherapy and infliximab monotherapy, and azathioprine and infliximab whether simultaneously or separately. We also compared the risk between male and female. Hazard ratio of tuberculosis in infliximab monotherapy, azathioprine, and combination therapy in IBD patients were 1.132, 1.256, and 2.118, respectively. Conclusion Our study shows that Korean IBD patients are at risk for tuberculosis, and this results may highlight the importance of screening for tuberculosis in IBD patients.

scholarly journals General and cancer specific mortality of a population based cohort of patients with inflammatory bowel disease: the Florence study

Gut ◽  
1998 ◽  
Vol 42 (2) ◽  
pp. 175-179 ◽  
Author(s):  
D Palli ◽  
G Trallori ◽  
C Saieva ◽  
O Tarantino ◽  
E Edili ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Population Based ◽  
Mediterranean Country ◽  
National Mortality ◽  
Increased Risk ◽  
Rectal Cancers ◽  
Standardised Mortality Ratios ◽  
Inflammatory Bowel

Background—A population based epidemiological study identified all the patients diagnosed with ulcerative colitis (UC) or Crohn’s disease (CD) resident in the Florence area in the period 1978–1992.Aims—To assess the mortality of unselected patients with inflammatory bowel disease (IBD) in a Mediterranean country.Methods—Overall, 920 patients (689 UC and 231 CD) were followed until death or end of follow up (31 December 1996). Information on vital status was available for all except eight patients (0.9%); 70 deaths were identified (23 in patients with CD and 47 in patients with UC). Expected deaths were estimated on the basis of five year age group, gender, and calendar year national mortality rates. Standardised mortality ratios (SMR) and 95% confidence intervals were calculated.Results—General mortality was significantly lower than expected in UC (SMR 0.6; 95% confidence interval 0.4 to 0.8), due to a reduced number of cardiovascular and, possibly, smoking related deaths. Cancers of the respiratory tract were significantly reduced in UC but tended to be increased in patients with CD. These latter patients had not only an increased cancer mortality but also a 40% increased risk of dying for all causes already evident in the first five year follow up period and persisting thereafter. In contrast, in patients with UC, SMRs were initially very low but tended to increase steadily over the follow up period. Gastrointestinal deaths were particularly increased in patients with CD, but only moderately in those with UC. Overall, there was some evidence of a twofold increased mortality for colorectal cancer, the risk being highest for rectal cancers in patients with UC. A non-significant excess of deaths due to haemolymphopoietic malignancies and suicides was also observed.Conclusions—This study, the first in a Mediterranean country, supports the existence of two divergent mortality patterns for patients with UC and CD, possibly explained by differences in smoking habits and by a greater severity of CD.

1012 Natural History of Inflammatory Bowel Disease in Asia: A Follow-Up Population-Based Cohort Study

2014 ◽  
Vol 146 (5) ◽  
pp. S-178
Author(s):  
Siew C. Ng ◽  
Whitney Tang ◽  
H.J. de Silva ◽  
Madunil A. Niriella ◽  
Yasith Udara Senanayake ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Cohort Study ◽  
Natural History ◽  
Bowel Disease ◽  
Population Based ◽  
History Of ◽  
Inflammatory Bowel
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