Iron deficiency anemia impacts disease progression and healthcare resource consumption in patients with inflammatory bowel disease: a real-world evidence study.

IF 4.2 3区医学

Therapeutic Advances in Gastroenterology Pub Date : 2023-01-01 DOI:10.1177/17562848231177153

Gionata Fiorino, Jean-Frederic Colombel, Kostas Katsanos, Fermín Mearin, Jürgen Stein, Margherita Andretta, Stefania Antonacci, Loredana Arenare, Rita Citraro, Stefania Dell'Orco, Luca Degli Esposti, Antonio Ramirez de Arellano Serna, Neige Morin, Ioannis E Koutroubakis

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引用次数: 1

Abstract

Background: Iron deficiency anemia (IDA) is a common extraintestinal manifestation of inflammatory bowel disease (IBD), affecting around one-third of patients.

Objective: To compare IBD progression and healthcare resource utilization in patients with and without a co-diagnosis of IDA in a real-world setting.

Design: A retrospective comparative study was conducted using Italian entities' administrative databases, covering 9.3 million health-assisted individuals.

Methods: Adult IBD patients diagnosed with ulcerative colitis and/or Crohn's disease were enrolled between January 2010 and September 2017. Within 12 months from IBD diagnosis, IDA was identified by at least one prescription for iron and/or IDA hospitalization and/or blood transfusion (proxy of diagnosis). IBD population was divided according to the presence/absence of IDA. Given the nonrandom patients' allocation, propensity score matching (PSM) was applied to abate potential unbalances between the groups. Before and after PSM, IBD progression (in terms of IBD-related hospitalizations and surgeries), and healthcare resource costs were assessed.

Results: Overall, 13,475 IBD patients were included, with an average age at diagnosis of 49.9 years, and a 53.9% percentage of male gender. Before PSM, 1753 (13%) patients were IBD-IDA, and 11,722 (87%) were IBD-non-IDA. Post-PSM, 1753 IBD-IDA patients were matched with 3506 IBD-non-IDA. Before PSM, IBD progression was significantly higher in IBD-IDA (12.8%) than in IBD-non-IDA (6.5%) (p < 0.001). After PSM, IBD progression and IBD-related hospitalizations were significantly (p < 0.001) more frequent in IBD-IDA patients (12.8% and 12.0%, respectively) compared to IBD-non-IDA (8.7% and 7.7%). Consistently, healthcare expenditures resulted significantly higher among IDA patients (p < 0.001), with an overall mean annual cost of €5317 compared to €2798 for patients without IDA. These results were confirmed after PSM matching, as the mean annual total cost/patient in IBD-IDA versus IBD-non-IDA were €3693 and €3046, respectively (p < 0.001).

Conclusion: In a real-life setting, IDA co-diagnosis in IBD patients was associated with disease progression and higher related economic burden.

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缺铁性贫血影响炎症性肠病患者的疾病进展和医疗资源消耗:一项真实世界的证据研究

背景:缺铁性贫血(IDA)是炎症性肠病(IBD)常见的肠外表现，约三分之一的患者受其影响。目的:比较现实世界中合并和未合并IDA的患者的IBD进展和医疗资源利用情况。设计:利用意大利实体的行政数据库进行了一项回顾性比较研究，涵盖了930万卫生援助人员。方法:纳入2010年1月至2017年9月期间诊断为溃疡性结肠炎和/或克罗恩病的成年IBD患者。在IBD诊断后的12个月内，通过至少一次铁处方和/或IDA住院和/或输血(替代诊断)来确定IDA。根据有无IDA划分IBD人群。考虑到患者的非随机分配，倾向评分匹配(PSM)被用于减少组间潜在的不平衡。在PSM之前和之后，评估IBD进展(根据IBD相关住院和手术)和医疗资源成本。结果:总体而言，纳入13475例IBD患者，平均诊断年龄为49.9岁，男性占53.9%。在PSM之前，1753例(13%)患者为IBD-IDA, 11722例(87%)患者为ibd -非ida。psm后，1753名IBD-IDA患者与3506名ibd -非ida患者配对。在PSM之前，IBD-IDA患者的IBD进展率(12.8%)显著高于IBD-非IDA患者(6.5%)(p / p分别为3693欧元和3046欧元)。结论:在现实生活中，IBD患者的IDA联合诊断与疾病进展和更高的相关经济负担相关。

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来源期刊

Therapeutic Advances in Gastroenterology Medicine-Gastroenterology

自引率

2.40%

发文量

103

期刊介绍： Therapeutic Advances in Gastroenterology is an open access journal which delivers the highest quality peer-reviewed original research articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of gastrointestinal and hepatic disorders. The journal has a strong clinical and pharmacological focus and is aimed at an international audience of clinicians and researchers in gastroenterology and related disciplines, providing an online forum for rapid dissemination of recent research and perspectives in this area. The editors welcome original research articles across all areas of gastroenterology and hepatology. The journal publishes original research articles and review articles primarily. Original research manuscripts may include laboratory, animal or human/clinical studies – all phases. Letters to the Editor and Case Reports will also be considered.