BACKGROUND: Hospitalization is an important outcome measure and a major driver of costs in patients with inflammatory bowel disease. We analysed medical and surgical hospitalization rates and predictors of hospitalization before and during anti-TNF therapy. METHODS: Data from 194 consecutive patients were analysed retrospectively (males, 45.4%, median age at diagnosis, 24.0 years, infliximab/adalimumab: 144/50) in whom anti-TNF therapy was started after January 1, 2008. Total follow-up was 1874 patient-years and 474 patient-years with anti-TNF exposure. RESULTS: Hospitalization rates hospitalization decreased only in Crohn's disease (odds ratio: 0.59, 95% confidence interval: 0.51-0.70, median 2-years' anti-TNF exposure) with a same trend for surgical interventions (p=0.07), but not in ulcerative colitis. Need for hospitalization decreased in Crohn's disease with early (within 3-years from diagnosis, p=0.016 by McNemar test), but not late anti-TNF exposure. At logistic regression analysis complicated disease behaviour (p=0.03), concomitant azathioprine (p=0.02) use, but not anti-TNF type, gender, perianal disease or previous surgeries were associated with the risk of hospitalization during anti-TNF therapy. CONCLUSION: Hospitalization rate decreased significantly in patients with Crohn's disease but not ulcerative colitis after the introduction of anti-TNF therapy and was associated with time to therapy. Complicated disease phenotype and concomitant azathioprine use were additional factors defining the risk of hospitalization.
BACKGROUND: Hospitalization is an important outcome measure and a major driver of costs in patients with inflammatory bowel disease. We analysed medical and surgical hospitalization rates and predictors of hospitalization before and during anti-TNF therapy. METHODS: Data from 194 consecutive patients were analysed retrospectively (males, 45.4%, median age at diagnosis, 24.0 years, infliximab/adalimumab: 144/50) in whom anti-TNF therapy was started after January 1, 2008. Total follow-up was 1874 patient-years and 474 patient-years with anti-TNF exposure. RESULTS: Hospitalization rates hospitalization decreased only in Crohn's disease (odds ratio: 0.59, 95% confidence interval: 0.51-0.70, median 2-years' anti-TNF exposure) with a same trend for surgical interventions (p=0.07), but not in ulcerative colitis. Need for hospitalization decreased in Crohn's disease with early (within 3-years from diagnosis, p=0.016 by McNemar test), but not late anti-TNF exposure. At logistic regression analysis complicated disease behaviour (p=0.03), concomitant azathioprine (p=0.02) use, but not anti-TNF type, gender, perianal disease or previous surgeries were associated with the risk of hospitalization during anti-TNF therapy. CONCLUSION: Hospitalization rate decreased significantly in patients with Crohn's disease but not ulcerative colitis after the introduction of anti-TNF therapy and was associated with time to therapy. Complicated disease phenotype and concomitant azathioprine use were additional factors defining the risk of hospitalization.
Authors: Siddharth Singh; James A Proudfoot; Parambir S Dulai; Ronghui Xu; Brian G Feagan; William J Sandborn; Vipul Jairath Journal: Clin Gastroenterol Hepatol Date: 2019-05-18 Impact factor: 11.382
Authors: Christopher Ma; Candace L Beilman; Vivian W Huang; Darryl K Fedorak; Karen Wong; Karen I Kroeker; Levinus A Dieleman; Brendan P Halloran; Richard N Fedorak Journal: Can J Gastroenterol Hepatol Date: 2016-07-11
Authors: David M Faleck; Adam Winters; Shreya Chablaney; Preeti Shashi; Joseph Meserve; Aaron Weiss; Satimai Aniwan; Jenna L Koliani-Pace; Gursimran Kochhar; Brigid S Boland; Siddharth Singh; Robert Hirten; Eugenia Shmidt; Varun Kesar; Karen Lasch; Michelle Luo; Matthew Bohm; Sashidhar Varma; Monika Fischer; David Hudesman; Shannon Chang; Dana Lukin; Keith Sultan; Arun Swaminath; Nitin Gupta; Corey A Siegel; Bo Shen; William J Sandborn; Sunanda Kane; Edward V Loftus; Bruce E Sands; Jean-Frederic Colombel; Parambir S Dulai; Ryan Ungaro Journal: Clin Gastroenterol Hepatol Date: 2019-01-06 Impact factor: 11.382
Authors: Zsuzsanna Kurti; Akos Ilias; Lorant Gonczi; Zsuzsanna Vegh; Petra Fadgyas-Freyler; Gyula Korponay; Petra A Golovics; Barbara D Lovasz; Peter L Lakatos Journal: BMC Gastroenterol Date: 2018-01-30 Impact factor: 3.067