Rural and Urban Differences in the Risk of Inflammatory Bowel Disease and Subsequent Health Services Utilization in Ontario

Kuenzig, M Ellen; Nguyen, Geoffrey C.; Benchimol, Eric I

doi:10.12927/hcq.2019.25913

Cited by 6 publications

(5 citation statements)

References 22 publications

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“…IBD is a disease that occurs most frequently in countries with high socio-economic development, with incidence and prevalence particularly high in Europe and North America [4][5][6][7]. Within Western countries, people in urban areas are more prone to IBD compared to those in rural areas, and this is probably due to differences in lifestyle, resulting in greater exposure to IBD risk factors [8].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Multiple Sclerosis in Patients with Inflammatory Bowel Disease

Pérez-Díaz-del-Campo

Caviglia

Piana

et al. 2023

Gastrointestinal Disorders

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Being two immune-mediated diseases (IMIDs), the association between multiple sclerosis (MS) and inflammatory bowel disease (IBD) is plausible, but data in the literature are conflicting. The aim of our study was to evaluate the possible association between IBD and MS in a cohort of patients with IBD. In a retrospective study, we examined the medical records of 5739 patients with a confirmed diagnosis of IBD followed in our clinic between 1978 and 2022. Among these patients, we identified 14 with MS, with a prevalence of 0.24%. The reported prevalence of MS in the general population in Northern Italy in 2021 was 0.18% (p = 0.24). For each of the patients with MS identified, more than ten patients without MS were analyzed. The 14 MS cases were then compared with 342 controls. From the 14 patients with MS, 12 (85.7%) were female and 2 (14.3%) were male, while in the control group, 158 (46.2%) were female and 184 (53.8%) were male (p = 0.004). As for therapy, significant differences were found in mesalazine (5 (41.7%) cases vs. 317 (92.7%) controls, p < 0.0001) and anti-TNF treatment (0% cases vs. 26.6% controls, p = 0.03, respectively) at the time of MS diagnosis. Moreover, a Kaplan–Meier curve analysis showed that the 20-year survival probability was 98.4% for patients with IBD, while for patients diagnosed with MS and IBD it was 82.1% (p = 0.02). In conclusion, patients with IBD have a similar risk of developing MS compared to the general population, but female sex appears to increase the risk. Indeed, life expectancy at 20 years for patients with IBD and MS is lower than for patients with IBD alone.

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Section: Introductionmentioning

confidence: 99%

Prevalence of Multiple Sclerosis in Patients with Inflammatory Bowel Disease

Pérez-Díaz-del-Campo

Caviglia

Piana

et al. 2023

Gastrointestinal Disorders

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“…In a Canadian population study, Kuenzig et al. observed that patients from rural zones were less likely to be treated by a specialist gastroenterologist and presented a higher rate of comorbidities and infectious diseases than patients from urban areas [ 41 ]. Even in a smaller territory like Catalonia, where distances to acute hospital care is in average less than 20 Km [ 42 ], the access to IBD specialists and IBD units differs in rural and urban areas.…”

Section: Discussionmentioning

confidence: 99%

Heterogeneity in pharmacological treatment and outcomes in Crohn’s disease patients in Catalonia: a population-based observational study

Brunet

Vela

Melcarne³

et al. 2022

Annals of Medicine

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Background Heterogeneity in the treatment of a disease is a marker of suboptimal quality of care. The aim of this study is to evaluate the heterogeneity in the treatment used and the outcomes for Crohn’s disease (CD) in Catalonia. Methods All patients with CD included in the Catalan Health Surveillance System (data on more than seven million individuals from 2011 to 2017) were identified. The different Catalonian health areas were grouped into 19 district groups (DG). Treatments used rates (systemic corticosteroids, non-biological and biological immunosuppressant) and outcomes rates (hospitalization and surgery) were calculated. Results The use of systemic corticosteroids presented a decreasing trend over the study period, with an average rate of use in the different territories between 11% and 17%. The use of non-biological immunosuppressant treatment has remained stable, with an average rate of use ranging from 22% to 40% per year depending on the DG. The use of biological immunosuppressant treatment increased with an average rate of use in the different territories ranging from 10 to 23%. Hospitalizations for any reason showed an increasing trend between 2011 and 2017 with an average rate of between 23% and 32% per year depending on the area. Hospitalizations for CD presented a decreasing trend, with an average rate of between 5% and 11% per year. Surgical treatment remained stable over time, rates per year were between 0.5% and 2%. Conclusion A remarkable geographical heterogeneity in the use of different treatments and in outcomes of CD was observed between different geographical areas of Catalonia. KEY MESSAGE There is a notable geographical heterogeneity in the administration of biological and immunosuppressive treatments to Crohn’s disease patients in Catalonia. There is also a geographical heterogeneity in their rates of hospitalization and surgical intervention.

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“…This seems to suggest a fundamental role of environmental risk factors in the development of the pathology [3]. Within Western countries themselves there is a different incidence between urban and rural areas: the population of the former is in fact more subject to cases of IBDs and this is probably due to the differences in lifestyle, which determine greater exposure to risk factors for CD [4].…”

Section: Introductionmentioning

confidence: 99%

Correlation between Polymorphisms of Vitamin D Metabolism Genes and Perianal Disease in Crohn’s Disease

Cusato,

Cafasso,

Antonucci

et al. 2024

Biomedicines

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Although the role of vitamin D (VD) in the pathogenesis and progression of Crohn’s disease (CD) is known, the association between single-nucleotide polymorphisms (SNPs) of genes linked to vitamin D pathway and CD risk is still under study. Furthermore, no significant association has been previously found between these SNPs and perianal CD (pCD), a severe phenotypic manifestation of CD that may present as perianal fistula, abscess, and recto-vaginal fistula. Among the mechanisms involved in its pathogenesis, local inflammation and intestinal microbiota alteration are recognized. VD seems to act on these elements. The aim of this study was to evaluate the presence of an association between SNPs of genes coding for enzymes, transporters, and receptors involved in the VD pathway and the occurrence of pCD. Blood samples of 206 patients with CD, including 34 with pCD, were analyzed for VDR, CYP27B1, CYP24A1, and GC genetic variants. VDR Apal Aa genotype and VDR BsmI Bb genotype resulted in an association with pCD (p = 0.01 and p = 0.02, respectively). Our study demonstrates for the first time the impact of the polymorphisms of genes associated with the VD pathway on the onset of pCD. Future multicenter studies are needed to confirm these data.

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Rural and Urban Differences in the Risk of Inflammatory Bowel Disease and Subsequent Health Services Utilization in Ontario

Cited by 6 publications

References 22 publications

Prevalence of Multiple Sclerosis in Patients with Inflammatory Bowel Disease

Prevalence of Multiple Sclerosis in Patients with Inflammatory Bowel Disease

Heterogeneity in pharmacological treatment and outcomes in Crohn’s disease patients in Catalonia: a population-based observational study

Correlation between Polymorphisms of Vitamin D Metabolism Genes and Perianal Disease in Crohn’s Disease

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