Trends in hospitalisation rates for inflammatory bowel disease in western versus newly industrialised countries: a population-based study of countries in the Organisation for Economic Co-operation and Development

King, James; Underwood, Fox E.; Panaccione, Nicola; Quan, Joshua; Windsor, Joseph W.; Kotze, Paulo Gustavo; Ng, Siew C.; Ghosh, Subrata; Lakatos, László; Jess, Tine; Panaccione, Remo; Seow, Cynthia H.; Ben‐Horin, Shomron; Burisch, Johan; Colombel, Jean Fréd́eric; Loftus, Edward V.; Gearry, Richard B.; Halfvarson, Jonas; Kaplan, Gilaad G.

doi:10.1016/s2468-1253(19)30013-5

Cited by 48 publications

(32 citation statements)

References 29 publications

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“…Hospitalization is frequent in IBD patients due to a remitting–relapsing disease course . In accordance with the high prevalence of IBD in North America, Europe and Oceania, these regions also have the highest rates of hospitalization among IBD patients when compared to Asia, Latin American and the Caribbean . In UC, 23% and 30% of patients in the Epi‐IBD cohort and Olmsted County cohorts, respectively, were hospitalized at least once because of IBD within five years after their diagnosis.…”

Section: Disease Course Of Ibdmentioning

confidence: 92%

“…When looking at the trends in hospitalization rates, recent data reveal a significant increase in Asia, with an AAPC at +3.8% and + 5.4% in Japan and South Korea, respectively. Meanwhile, the AAPC in western countries such as Denmark and Canada is decreasing, with an AAPC of −1.2% and − 1.7%, respectively …”

Section: Disease Course Of Ibdmentioning

confidence: 99%

“…Meanwhile, the AAPC in western countries such as Denmark and Canada is decreasing, with an AAPC of À1.2% and À 1.7%, respectively. 50 Development of colorectal cancer. Population-based studies from western populations have shown an increased rate of colorectal cancer (CRC) in UC patients compared to the general population with a pooled standardized incidence ratio (SIR) of 2.4 (95% CI 2.1-2.7).…”

Section: Disease Course Of Ibdmentioning

confidence: 99%

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The epidemiology of inflammatory bowel disease: East meets west

Mak

Zhao

et al. 2019

J of Gastro and Hepatol

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422

291

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The incidence of inflammatory bowel diseases (IBD) in East has risen over the past decade to become a global disease. The increasing number of studies on the incidence and course of IBD in East has enabled us to explore East versus West differences in the epidemiology of IBD which could enhance our understanding of the heterogeneity of the disease and eventually assist in the discovery of novel therapeutic targets and design of preventive strategies. Comparison of population‐based data in East and West reveals that the incidence of IBD has risen rapidly in East while plateauing in West. Furthermore, the clinical presentation and course of IBD differs between East and West with more patients in East presenting with complicated disease. Considering the scarcity of population‐based data from East and the lack of studies with long durations of follow‐up, it remains to be clarified whether these differences reflect true differences in disease presentation. The effects of genetic and environmental risk factors contributing to IBD also differ between Eastern and Western populations. Considering the differential effects of genetic and environmental risk factors in East and West, future studies should seek to discover novel genetic and environmental risk factors which might specifically apply to eastern populations. In this narrative review, we compare the epidemiology of IBD between eastern and western countries by summarizing evidence from population‐based cohort studies in the last ten years. Furthermore, we look at differences in genetic susceptibility and environmental triggers of IBD between East and West.

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Section: Disease Course Of Ibdmentioning

confidence: 92%

Section: Disease Course Of Ibdmentioning

confidence: 99%

Section: Disease Course Of Ibdmentioning

confidence: 99%

See 1 more Smart Citation

The epidemiology of inflammatory bowel disease: East meets west

Mak

Zhao

et al. 2019

J of Gastro and Hepatol

Self Cite

422

291

View full text Add to dashboard Cite

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“…Medical management was revolutionized with the introduction of biologics—the first being the tumour necrosis factor (TNF) antagonist, infliximab (Remicade), with approval for Crohn’s disease in 2000. Since 2000, rates of hospitalizations and surgeries for Crohn’s disease and ulcerative colitis have steadily decreased across Canada ( 4 ). For example, a population-based study in the Calgary Zone demonstrated that from 2002 to 2010, surgical resections fell significantly by 3.5% per year, which was driven by a substantial 10.1% annual decrease in emergency operations for patients with Crohn’s disease, much of which is attributable to the introduction of TNF antagonists ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

The Argument Against a Biosimilar Switch Policy for Infliximab in Patients with Inflammatory Bowel Disease Living in Alberta

Kaplan

Seow

et al. 2020

Journal of the Canadian Association of Gastroenterology

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A nonmedical switch policy is currently being considered in Alberta, which would force patients on originator biologics to biosimilar alternatives with the hypothetical aim of reducing costs to the health care system. The evidence to support the safety of nonmedical switching in patients with inflammatory bowel disease (IBD) is of low to very low quality; in fact, existing data suggest a potential risk of harm. In a pooled analysis of randomized controlled trials, one patient would lose response to infliximab for every 11 patients undergoing nonmedical switching. Switching to a biosimilar has important logistical and ethical implications including potential forced treatment changes without appropriate patient consent and unfairly penalizing patients living in rural areas and those without private drug insurance. Even in the best-case scenario, assuming perfectly executed switching without logistical delays, we predict switching 2,000 patients with Remicade will lead to over 60 avoidable surgeries in Alberta. Furthermore, nonmedical switching has not been adequately studied in vulnerable populations such as children, pregnant women, and elderly patients. While the crux of the argument for nonmedical switching is cost savings, biosimilar switching may not be cost effective: Particularly when originator therapies are being offered at the same price as biosimilars. Canadian patients with IBD have been surveyed, and their response is clear: They are not in support of nonmedical switching. Policies that directly influence patient health need to consider patient perspectives. Solutions to improve cost efficiency in health care exist but open, transparent collaboration between all involved stakeholders is required. Key Messages • The evidence evaluating the safety of nonmedical switching to a biosimilar is of very low quality and suggests potential harm to patients with IBD. • A meta-analysis of randomized controlled trials demonstrated that one patient is expected to lose response to their infliximab for every 11 patients who are switched to a biosimilar. • A nonmedical switch policy is expected to cause over 60 avoidable surgeries in Alberta. • Nonmedical switching has not been adequately studied in highly vulnerable populations including children, pregnant women and elderly patients. • Nonmedical switching has important logistical and ethical implications. • Biosimilar switching may not be cost effective, particularly when originator therapies are offered at the same price as biosimilars. • Canadian patients with IBD have significant anxiety and concern over switching.

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“…However, how they affect surgical rates and long-term outcomes is still under investigation. Although several studies have reported short-term trends and hospitalization costs of IBD in China 3 [6][7][8] , longitudinal trends of IBD in China still remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Increasing Newly Diagnosed Inflammatory Bowel Disease and Improving Prognosis in China: A 30-year Retrospective Study From a Single Center

Jin

Zhang

et al. 2020

Preprint

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Background: We aimed to characterize the trends of prognosis in Ulcerative Colitis (UC) and Crohn’s Disease (CD) in a Chinese tertiary hospital. Methods: A 30-year retrospective cohort analysis was conducted at Peking Union Medical College Hospital. Consecutive patients newly diagnosed with UC or CD from 1985 to 2014 were included. The primary outcome was in-hospital mortality. Second outcomes included surgery and length of stay in hospital. Pearson correlation coefficient was performed to determine the relationship between time and prognosis. Multivariable logistic regression analysis was performed to determine the risk factors for in-hospital mortality and surgery. Results: In total, 1467 patients were included in this study (898 cases with UC and 569 cases with CD). Annual admissions of UC and CD rose significantly over the last 30 years (UC, r=0.918, P<0.05; CD, r=0.898, P<0.05). Decreased in-hospital mortalities were observed in patients with UC and CD (UC, from 2.44% to 0.27%, r=-0.827, P<0.05; CD, from 12.50% to 0.00%, r=-0.978, P<0.05). A decreasing surgery rate was observed in patients with CD (r=-0.847, P<0.05) while an increasing surgery rate was observed in patients with UC (r=0.956, P<0.05). Shortened average lengths of stay in hospital were observed both in patients with UC and CD (UC, from 47.83±34.35 days to 23.58±20.05 days, r=-0.970, P<0.05; CD, from 65.50±50.57days to 26.41±18.43 days, r=-0.913, P<0.05). Toxic megacolon, sepsis shock were independent risk factors for in-hospital mortality in patients with UC. Intestinal fistula, intestinal perforation were independent risk factors for in-hospital mortality in patients with CD. Conclusions: In this cohort, the admissions of patients with UC and CD were increased with a significantly improved prognosis during past 30 years.

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Trends in hospitalisation rates for inflammatory bowel disease in western versus newly industrialised countries: a population-based study of countries in the Organisation for Economic Co-operation and Development

Cited by 48 publications

References 29 publications

The epidemiology of inflammatory bowel disease: East meets west

The epidemiology of inflammatory bowel disease: East meets west

The Argument Against a Biosimilar Switch Policy for Infliximab in Patients with Inflammatory Bowel Disease Living in Alberta

Increasing Newly Diagnosed Inflammatory Bowel Disease and Improving Prognosis in China: A 30-year Retrospective Study From a Single Center

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