Intestinal complications in Brazilian patients with ulcerative colitis treated with conventional therapy between 2011 and 2020.

Autor:	Martins AL; Espirito Santo Health Office, State Office for Pharmaceutical Assistance, Espirito Santos 29056-030, Brazil., Galhardi Gasparini R; Department of Gastroenterology, Specialized Medical Center, Marília 17502-020, Brazil., Sassaki LY; Department of Gastroenterology, Sao Paulo State University, Medical School, Botucatu 18618-687, Brazil., Saad-Hossne R; Department of Gastroenterology, Sao Paulo State University, Medical School, Botucatu 18618-687, Brazil., Ritter AMV; Real World Evidence, IQVIA Brazil, Sao Paulo 04719-002, Brazil., Barreto TB; Department of Gastroenterology, Takeda Pharmaceuticals Brazil, Sao Paulo 04794-000, Brazil., Marcolino T; Department of Gastroenterology, Takeda Pharmaceuticals Brazil, Sao Paulo 04794-000, Brazil., Yang Santos C; Department of Gastroenterology, Takeda Pharmaceuticals Brazil, Sao Paulo 04794-000, Brazil. clausantos2910@gmail.com.
Jazyk:	angličtina
Zdroj:	World journal of gastroenterology [World J Gastroenterol] 2023 Feb 28; Vol. 29 (8), pp. 1330-1343.
DOI:	10.3748/wjg.v29.i8.1330
Abstrakt:	Background: This was an observational, descriptive, and retrospective study from 2011 to 2020 from the Department of Informatics of the Brazilian Healthcare System database. Aim: To describe the intestinal complications (IC) of patients with ulcerative colitis (UC) who started conventional therapies in Brazil´s public Healthcare system. Methods: Patients ≥ 18 years of age who had at least one claim related to UC 10 th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) code and at least 2 claims for conventional therapies were included. IC was defined as at least one claim of: UC-related hospitalization, procedures code for rectum or intestinal surgeries, and/or associated disease defined by ICD-10 codes (malignant neoplasia of colon, stenosis, hemorrhage, ulcer and other rectum or anus disease, megacolon, functional diarrhea volvulus, intussusception and erythema nodosum). Descriptive statistics, annual incidence, and incidence rate (IR) [per 100 patient-years (PY)] over the available follow-up period were cal-culated. Results: In total, 41229 UC patients were included (median age, 48 years; 65% women) and the median (interquartile range) follow-up period was 3.3 (1.8-5.3) years. Conventional therapy used during follow-up period included: mesalazine (87%), sulfasalazine (15%), azathioprine (16%) or methotrexate (1%) with a median duration of 1.9 (0.8-4.0) years. Overall IR of IC was 3.2 cases per 100 PY. Among the IC claims, 54% were related to associated diseases, 20% to procedures and 26% to hospitalizations. The overall annual incidence of IC was 2.9%, 2.6% and 2.5% in the first, second and third year after the first claim for therapy (index date), respectively. Over the first 3 years, the annual IR of UC-related hospitalizations ranged from 0.8% to 1.1%; associated diseases from 0.9% to 1.2% - in which anus or rectum disease, and malignant neoplasia of colon were the most frequently reported; and procedure events from 0.6% to 0.7%, being intestinal resection and polyp removal the most frequent ones. Conclusion: Study shows that UC patients under conventional therapy seem to present progression of disease developing some IC, which may have a negative impact on patients and the burden on the health system. Competing Interests: Conflict-of-interest statement: Martins AL served on the advisory board of Takeda, AbbVie, Janssen, Pfizer and Amgen and is a speaker for Amgen and Janssen. Galhardi Gasparini R is a speaker for Janssen, Takeda and AbbVie. Sassaki LY is a speaker for Janssen and Takeda and participated in the advisory boards of Takeda and AbbVie. Saad-Hossne R is a speaker and on the advisory boards for AbbVie, Takeda, Janssen, Pfizer, Fresenius and Amgen, as well as a speaker for Novartis. AMVR is an employee of IQVIA Brazil. Marcolino T, Barreto TB and Yang Santos C are employees of Takeda Pharmaceutical Brazil. (©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.)
Databáze:	MEDLINE
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