Temporal Trends in Surgical Resection Rates and Biologic Prescribing in Crohn's Disease: A Population-based Cohort Study

Autor:	David C. Wilson, Nikolas Plevris, Philip Jenkinson, Angus Watson, S Siakavellas, Charlie W. Lees, Mathew Lyons, G R Jones, I. D. R. Arnott
Rok vydání:	2020
Předmět:	Adult Male medicine.medical_specialty Medication Therapy Management Population Anti-Inflammatory Agents Antibodies Monoclonal Humanized Vedolizumab Cohort Studies Crohn Disease Internal medicine Outcome Assessment Health Care medicine Humans Medical prescription Practice Patterns Physicians' education Digestive System Surgical Procedures education.field_of_study Biological Products Proportional hazards model business.industry Patient Selection Hazard ratio Gastroenterology Adalimumab Retrospective cohort study General Medicine Infliximab United Kingdom Cohort Female Ustekinumab business medicine.drug
Zdroj:	Jenkinson, P W, Plevris, N, Siakavellas, S, Lyons, M, Arnott, I D, Wilson, D, Watson, A J M, Jones, G & Lees, C W 2020, ' Temporal Trends in Surgical Resection Rates and Biologic Prescribing in Crohn’s Disease : A Population-based Cohort Study ', Journal of Crohn's and Colitis, vol. 14, no. 9, pp. 1241-1247 . https://doi.org/10.1093/ecco-jcc/jjaa044
ISSN:	1876-4479
DOI:	10.1093/ecco-jcc/jjaa044
Popis:	Background The use of biologic therapy for Crohn’s disease [CD] continues to evolve, however, the effect of this on the requirement for surgery remains unclear. We assessed changes in biologic prescription and surgery over time in a population-based cohort. Methods We performed a retrospective cohort study of all 1753 patients diagnosed with CD in Lothian, Scotland, between January 1, 2000 and December 31, 2017, reviewing the electronic health record of each patient to identify all CD-related surgery and biologic prescription. Cumulative probability and hazard ratios for surgery and biologic prescription from diagnosis were calculated and compared using the log-rank test and Cox regression analysis stratified by year of diagnosis into cohorts. Results The 5-year cumulative risk of surgery was 20.4% in cohort 1 [2000–2004],18.3% in cohort 2 [2005–2008], 14.7% in cohort 3 [2009–2013], and 13.0% in cohort 4 [2014–2017] p Conclusions The increased and earlier use of biologic therapy in CD patients corresponded with a decreasing requirement for surgery over time within our cohort. This could mean that adopting a top-down or accelerated step-up treatment strategy may be effective at reducing the requirement for surgery in newly diagnosed CD.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::dde0c82228aafa6645c9fe44c15fb26e https://pubmed.ncbi.nlm.nih.gov/32840295 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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