Inflammatory Bowel Disease in the Post-STRIDE II Era: Epidemiology and Long-Term Clinical Outcomes from a Population-Based Study.

Q1 Medicine
Fabio Ingravalle, Marco Valvano, Andrea Barbara, Dorian Bardhi, Giovanni Latella, Angelo Viscido, Mariachiara Campanale, Antonio Vinci, Carlo Viora, Giampiera Bulfone, Rocco Mazzotta, Massimo Maurici
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Abstract

Background/Objectives: Inflammatory bowel disease (IBD) includes Crohn's disease (CD) and ulcerative colitis (UC). The availability of an increasing number of new molecules approved for IBD treatment has increased our ability and aspirations to change the trajectory of the disease. The Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) II consensus (2018) is the current suggested strategy for IBD management, which recommends a treat-to-target approach. The primary objective of this study is to describe the clinical history of IBD in the post-STRIDE II era and to quantify the burden of IBD in terms of hospitalisation rate. The secondary objective is to estimate the 6-year risk of intestinal resection among IBD patients. Methods: A population-based time series analysis was conducted on administrative data; retrospective data from January 2011 to December 2021 were collected for the Local Health Authority "Roma 1" population (∼1.5 million residents). Hospitalisation and surgical events were prospectively recorded for patients newly diagnosed between January 2018 and February 2022 (n = 556), with follow-up throughout May 2024. A Kaplan-Mayer survivor analysis was performed to estimate the cumulative surgery risk. Results: In 2021, the IBD prevalence was 218.3 cases/100,000 people (77.2 CD, 141.1 UC). The incidence trend slowly increased during the last decade, up to 5.3 (CD) and 9.4 (UC) cases/100,000 ppl/year. The yearly hospitalisation rate remained stable, near 16.5%. The 6-year cumulative risk of surgery was 36% for CD and 20% for UC. Conclusions: The incidence of IBD has increased in the last few decades, with substantial stability in regard to the incidence of surgery and hospitalisations. Thus, the current IBD management approach has only had a small effect on changing the natural history of the disease.

后stride II时代的炎症性肠病:基于人群的研究的流行病学和长期临床结果
背景/目的:炎症性肠病(IBD)包括克罗恩病(CD)和溃疡性结肠炎(UC)。越来越多的新分子被批准用于IBD治疗,这增加了我们改变疾病发展轨迹的能力和愿望。炎症性肠病选择治疗靶点(STRIDE) II共识(2018)是目前IBD管理的建议策略,它推荐了一种治疗到靶点的方法。本研究的主要目的是描述后stride II时代IBD的临床病史,并根据住院率量化IBD的负担。次要目的是评估IBD患者6年肠切除术的风险。方法:对行政数据进行基于人群的时间序列分析;收集了2011年1月至2021年12月地方卫生局“罗姆1号”人口(约150万居民)的回顾性数据。前瞻性记录2018年1月至2022年2月期间新诊断的患者的住院和手术事件(n = 556),随访至2024年5月。Kaplan-Mayer幸存者分析评估累积手术风险。结果:2021年,IBD患病率为218.3例/10万人(77.2例CD, 141.1例UC)。在过去十年中,发病率呈缓慢上升趋势,达到5.3例(CD)和9.4例(UC) /10万ppl/年。年住院率保持稳定,接近16.5%。CD和UC的6年累积手术风险分别为36%和20%。结论:在过去的几十年里,IBD的发病率有所增加,手术和住院的发病率基本稳定。因此,目前的IBD管理方法对改变疾病的自然史只有很小的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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CiteScore
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