Has the Incidence of Inflammatory Bowel Disease Peaked? Evidence From the Population-Based NorDIBD Cohort 1978–2020

Larsen, Lone; Sandri, Anastasia Karachalia; Fallingborg, Jan; Jacobsen, Bent Ascanius; Jacobsen, Helle J.; Bøgsted, Martin; Drewes, Asbjørn Mohr; Jess, Tine

doi:10.14309/ajg.0000000000002187

Cited by 17 publications

(13 citation statements)

References 21 publications

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“…1 IBD is most prevalent in high-income countries whilst its incidence is most rapidly increasing in newly industrialised countries. 2 Approximately 0.5% of the Danish population had an IBD diagnosis in 2010 and by 2020, this rose to almost 0.75% as IBD prevalence increased by 63.3%, 3 supporting the projection that 1% of individuals within high-income countries will have an IBD diagnosis by 2030. 1 The pathophysiology of IBD involves complex genetic, environmental, epithelial, microbial, and immune factors 4 that result in immune dysfunction leading to gastrointestinal barrier dysregulation, and gut dysbiosis.…”

Section: Introductionmentioning

confidence: 84%

Risk of Inflammatory Bowel Disease Following Hospitalisation with Infectious Mononucleosis: A Danish Nationwide Cohort Study (1977-2021)

Ebert,

Harper,

Vestergaard

et al. 2024

Preprint

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Background:Infectious mononucleosis (IM) is a largely self-limiting syndrome mainly affecting adolescents and young adults but can present as a more severe disease requiring hospitalisation. The infectious agent most commonly causing IM, Epstein-Barr virus (EBV) has been associated with the development of several immune-mediated and inflammatory diseases.Objective:To investigate the risk of inflammatory bowel disease (IBD) following hospitalisation with severe IM.Methods:Danish nationwide registries were used to identify severe IM patients and sex-, age- and municipality- matched non-IM hospitalised controls, from 1st January 1977 to 31st December 2022. We undertook Cox regression modelling to calculate the hazards (HR) and 95% CI of IBD diagnosis, including Crohn's disease (CD) and ulcerative colitis (UC). Analyses were stratified by sex and age at IM hospitalisation.Results:We identified 39,684 patients with severe IM who were sex-, age-, and municipality-matched to 396,840 non-IM hospitalised controls. Severe IM was significantly associated with the development of IBD (HR:1.35; 95% CI: 1.22-1.49) and this was seen particularly in CD (HR: 1.56; 95% CI: 1.34-1.83) and to a lesser extent in UC (HR: 1.23; 95% CI: 1.08-1.40). Sex at severe IM diagnosis was not found to be a significant modifier to the risk of IBD development with risk increased in both females (HR: 1.36; 95% CI: 1.20-1.55) and males (HR: 1.34; 95% CI: 1.17-1.54). Only those receiving a severe IM diagnosis at 10-16 years (HR: 1.42; 95% CI:1.22-1.64) or 17-29 years (HR: 1.34; 95% CI:1.15-1.56) were at increased risk of IBD development.Conclusion:This study demonstrated an association between IM hospitalisation and later IBD development, indicating an association between severe EBV disease and IBD development. Further exploration of factors contributing to IBD susceptibility following EBV infection is warranted.

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Section: Introductionmentioning

confidence: 84%

Risk of Inflammatory Bowel Disease Following Hospitalisation with Infectious Mononucleosis: A Danish Nationwide Cohort Study (1977-2021)

Ebert,

Harper,

Vestergaard

et al. 2024

Preprint

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“…However, estimates have varied widely, ranging from 4.3 to 23.0 per 100,000 PYR (previous IBD estimates from Nordic countries are summarised in Additional file 1 : Table 1). These reported discrepancies in IBD risk may be attributed to population characteristics (e.g., age) and variations in definitions of IBD and how IBD was identified (register-based vs medical records) [ 28 – 33 ]. The sharp increase in incidence in late teenage years must be considered when comparing studies with different age cut-offs.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology, validation, and clinical characteristics of inflammatory bowel disease: the ABIS birth cohort study

et al. 2023

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Background Birth cohort studies with linked register-based data on inflammatory bowel disease (IBD) provide opportunities to prospectively study early-life determinants of the disease. However, register-based data often lack information on clinical characteristics and rely on diagnostic algorithms. Within the All Babies in Southeast Sweden (ABIS) cohort, we examined the validity of a register-based definition of IBD, its incidence, and clinical and therapeutic characteristics at diagnosis. Methods We followed 16,223 children from birth (1997–1999) until the end of 2020 for the diagnosis of IBD as defined by a minimum of two diagnostic codes for IBD in the Swedish National Patient Register (NPR). We described the incidence and cumulative incidence of IBD. Through a medical record review of cases diagnosed by the end of 2017, we examined the positive predictive value (PPV) for IBD and described its clinical characteristics and treatment. Results By 2020, at an average age of 22.2 years, 113 participants (0.74%, 95% confidence interval [CI] = 0.61–0.89) had a register-based diagnosis of IBD, corresponding to an incidence of 31.3 per 100,000 person-years of follow-up; the incidence for Crohn’s disease (CD) was 11.1 per 100,000 person-years and 15.8 for ulcerative colitis (UC). Of 77 participants with a register-based definition of IBD by the end of 2017, medical records were identified for 61 participants, of whom 57 had true IBD (PPV = 93%; 95%CI = 0.87–1.00). While oral 5-aminosalicylic acid treatment was equally common in newly diagnosed CD and UC patients, biologics were more often used for newly diagnosed CD. The median faecal calprotectin levels were 1206 mg/kg at diagnosis and 93 mg/kg at the last follow-up (P < 0.001). Conclusions In this population-based sample of Swedish children and young adults the cumulative IBD incidence was 0.74. The validity of register-based definition of IBD was high and supports using such data to identify IBD patients in cohort studies.

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“…This issue highlights topics such as the role of maternal inflammatory bowel disease (IBD) on offspring and the impact of immunomodulator therapy on pediatric IBD (9,13). In the older population, the population peak of IBD and the ability to afford medications also underlines the multiple different ways the disease can affect patients and healthcare systems (23). Exciting data on celiac disease antibody dynamics and incidence of celiac disease in children also rounds out the differential impact of this condition in early stages of life (24).…”

Section: Autoimmune and Inflammatory Diseases Across The Lifespanmentioning

confidence: 99%

Exploring GI Diseases Across the Lifespan

Bajaj

Long

2022

Am J Gastroenterol

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Has the Incidence of Inflammatory Bowel Disease Peaked? Evidence From the Population-Based NorDIBD Cohort 1978–2020

Cited by 17 publications

References 21 publications

Risk of Inflammatory Bowel Disease Following Hospitalisation with Infectious Mononucleosis: A Danish Nationwide Cohort Study (1977-2021)

Risk of Inflammatory Bowel Disease Following Hospitalisation with Infectious Mononucleosis: A Danish Nationwide Cohort Study (1977-2021)

Epidemiology, validation, and clinical characteristics of inflammatory bowel disease: the ABIS birth cohort study

Exploring GI Diseases Across the Lifespan

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