Epidemiological, Clinical, Patient-Reported and Economic Burden of Inflammatory Bowel Disease (Ulcerative colitis and Crohn’s disease) in Spain: A Systematic Review

Abstract

Introduction This study describes the epidemiological, clinical, patient-reported and economic burden of inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), in Spain. Methods A systematic review was performed of observational studies reporting the epidemiological, clinical, patient-reported and economic burden of IBD in the Spanish population, from 2011 to 2021. Original articles and conference abstracts published in English or Spanish were eligible. Results A total of 45 publications were included in the review. The incidence of IBD in adults ranged from 9.6 to 44.3 per 100,000 inhabitants (4.6 to 18.5 for CD and 3.4 to 26.5 for UC). The incidence increased between 1.5- and twofold from 2000 to 2016 (regionally). Up to 6.0% (CD) and 3.0% (UC) IBD-associated mortality was reported. Disease onset predominantly occurs between 30 and 40 years (more delayed for UC than CD). Most frequently reported gastrointestinal manifestations are rectal bleeding in UC and weight loss in CD. Extraintestinal manifestations (EIM) have been described in up to 47.4% of patients with CD and 48.1% of patients with UC. Psychiatric comorbidities were frequently reported in both CD and UC (depression up to 20% and anxiety up to 11%). Reduced health-related quality of life (HRQoL) compared to the general population was reported. Significant symptomatology was associated with high levels of anxiety, depression, stress and lower HRQoL. Main healthcare resources reported were emergency department visits (24.0%), hospitalization (14.7%), surgery (up to 11%) and use of biologics (up to 60%), especially in CD. Direct and indirect annual costs per patient with UC were €1754.1 and €399.3, respectively. Conclusion Patients with CD and UC present a high disease burden which negatively impacts their HRQoL, leading to elevated use of resources. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-023-02473-6.

Psychological symptoms and quality of life in patients with inflammatory bowel disease in China: A multicenter study

“…Similarly, an American study 37 also showed a higher incidence of UC than CD. Our findings also showed a higher prevalence of anxiety‐depression and poorer QoL in patients with UC compared with CD, which is consistent with the trend of some studies, 38,39 but inconsistent with the results of many studies in other countries 40–44 . In the studies by Caplan et al 39 .…”

“…and Ganguli et al., 38 the results obtained showed a higher QoL in the group of patients with CD, although none of these studies showed statistically significant differences between groups. However, among Western countries, a UK study 40 showed a higher prevalence of anxiety‐depression in CD than in UC, and a systematic review in Spain 41 showed a higher prevalence of anxiety‐depression in CD than in UC among adults. A study from Korea, 41 despite being an Asian country, showed a higher prevalence of anxiety‐depression in CD than in UC, although there was no statistical difference.…”

“…However, among Western countries, a UK study 40 showed a higher prevalence of anxiety‐depression in CD than in UC, and a systematic review in Spain 41 showed a higher prevalence of anxiety‐depression in CD than in UC among adults. A study from Korea, 41 despite being an Asian country, showed a higher prevalence of anxiety‐depression in CD than in UC, although there was no statistical difference. Meanwhile, a Spanish study 43 showed that QoL was worse in CD than in UC, and a Brazilian study 44 also showed that QoL scores were lower in UC than in CD.…”

“…Our findings also showed a higher prevalence of anxiety-depression and poorer QoL in patients with UC compared with CD, which is consistent with the trend of some studies, 38,39 but inconsistent with the results of many studies in other countries. [40][41][42][43][44] In the studies by Caplan et al 39 and Ganguli et al, 38 the results obtained showed a higher QoL in the group of patients with CD, although none of these studies showed statistically significant differences between groups. However, among Western countries, a UK study 40 showed a higher prevalence of anxiety-depression in CD than in UC, and a systematic review in Spain 41 showed a higher prevalence of anxiety-depression in CD than in UC among adults.…”

Is disease activity associated with social support and psychological distress in Crohn’s disease patients? Results of a cross-sectional study in a Chinese hospital population

“…At the same time, epidemiological studies have confirmed that there are significant gender differences in the incidence of IBD, and this difference shows significant regional differences. In the USA,45 Canada,46 47 Israel,28 Spain48 and Denmark,49 the incidence of women is higher than that of men. In Asian countries such as South Korea,50 India51 and China,52 the incidence is higher in men than in women.…”