Investigating the impact of steroid dependence on gastrointestinal surgical outcomes from UK Biobank.

Autor: Kartoun U; IBM Research, Cambridge, MA, USA., Koseki A; IBM Research, Tokyo, Japan., Kosugi A; IBM Research, Tokyo, Japan., Njoku K; Department of Internal Medicine, Morehouse School of Medicine, Atlanta, GA, USA., Yadete T; Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA., Koski E; IBM T.J. Watson Research Center, Yorktown Heights, NY, USA., Bettencourt-Silva J; IBM Research Europe, Dublin, Ireland., Mulligan N; IBM Research Europe, Dublin, Ireland., Hu J; IBM T.J. Watson Research Center, Yorktown Heights, NY, USA., Liu J; Department of Internal Medicine, Morehouse School of Medicine, Atlanta, GA, USA. jjliu@msm.edu., Stappenbeck T; Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA. stappet@ccf.org., Anand V; IBM Research, Cambridge, MA, USA. anand@us.ibm.com.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2024 Nov 25; Vol. 14 (1), pp. 29243. Date of Electronic Publication: 2024 Nov 25.
DOI: 10.1038/s41598-024-75215-5
Abstrakt: Although corticosteroids are an important treatment for inflammatory bowel disease (IBD) patients, many subjects develop dependence, leading to serious long-term side effects. We applied causal inference analyses to investigate the length of steroid use on reoperations in IBD patients. We identified subjects in the UK Biobank general practice dataset with at least one major GI surgery and followed them for at least 5 years to evaluate subsequent operations. We defined steroid dependence as at least 12 weeks of use (vs. acute steroid use) prior to baseline surgery. Of the 363 subjects included in our analyses, 163 (45%) were prescribed steroids on or before baseline surgery, and of these (N = 125 of 163, 77%) were dependent. Additional analyses for time-dependent data on prescriptions found a link between prescription length and reoperation. Among UC subjects with acute use, the odds of reoperation were significantly lower (OR: 0.32, 95% CI: 0.0-0.73). Steroid dependence resulted in a delay of reoperation (median 1.2 vs. 2.3 years, P = 0.01). Our findings indicate that long-term steroid use tends to increase the need for reoperation, whereas short-term use may reduce it.
Competing Interests: Declarations. Competing interests: Potential competing interests: The authors declare that this work was conducted free of commercial, financial, or non-financial relationships that could be interpreted as a potential conflict of interest. Uri Kartoun, Akira Koseki, Akira Koseki, Akihiro Kosugi, Eileen Koski, Joao Bettencourt-Silva, Natasha Mulligan, Jianying Hu, and Vibha Anand are employees of IBM. Dr. Julia Liu: Advisory Board Member for Janssen, Takeda, Bristol Myers Squibb, and Pfizer; Consultant to Janssen, Takeda, Bristol Myers Squibb, Eli Lilly, and Pfizer. Dr. Thad Stappenbeck is an advisor for Janssen and Abbvie and is a founder of Mobius Care. The remaining authors have no disclosures.
(© 2024. The Author(s).)
Databáze: MEDLINE
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