Trends and safety of small bowel endoscopy in Crohn's disease in Japan: a large-scale claims database analysis.

IF 4.7 Q2 GASTROENTEROLOGY & HEPATOLOGY

Intestinal Research Pub Date : 2026-10-06 DOI:10.5217/ir.2026.00149

Shuhei Hosomi, Yu Nishida, Tsuyoshi Yanagida, Koji Fujimoto, Rieko Nakata, Akinari Sawada, Hirotsugu Maruyama, Masaki Ominami, Yuji Nadatani, Shusei Fukunaga, Koji Otani, Yasuhiro Fujiwara

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引用次数: 0

Abstract

Background/aims: Evidence on the population-level utilization and safety of balloon-assisted endoscopy (BAE) and small bowel capsule endoscopy (SBCE) for Crohn's disease in Japan is limited. We aimed to characterize trends in BAE, SBCE, and patency capsule examination, as well as adverse events (AEs).

Methods: We analyzed the Medical Data Vision claims database. Annual utilization was assessed per patient-year for the complete calendar years 2009-2021. AEs were defined by claimsbased therapeutic interventions after procedures. The association between patency capsule examination and SBCE-related AEs was assessed using generalized estimating equations (GEE) adjusted for age, sex, and calendar year.

Results: Among 19,881 eligible patients with Crohn's disease, 4,657 BAE and 2,679 SBCE procedures were identified. Modality switching was uncommon, with 83.9% of patients with ≥2 examinations (n =1,683) undergoing the same modality at the second examination. Utilization of both modalities increased over time, and patency capsule examination before SBCE increased from 2013 to 2021. SBCE-related AEs were rare in patients with patency capsule examination compared to those without patency capsule examination (0.88% vs. 1.47%). In the main GEE analysis, patency capsule examination was not independently associated with lower odds of SBCE-related AEs (adjusted odds ratio, 0.62; 95% confidence interval, 0.28-1.37; P= 0.235), with a similar result in sensitivity analyses.

Conclusions: The use of BAE and SBCE has increased in Japan alongside the spread of patency capsule examination. SBCE-related AEs were uncommon overall and numerically less frequent when preceded by patency assessment.

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日本克罗恩病小肠内窥镜检查的趋势和安全性：一项大规模索赔数据库分析。

背景/目的：在日本，关于克罗恩病的气球辅助内镜（BAE）和小肠胶囊内镜（SBCE）在人群水平上的使用和安全性的证据有限。我们的目的是描述BAE、SBCE和通畅胶囊检查的趋势，以及不良事件（ae）。方法：对Medical Data Vision索赔数据库进行分析。评估了2009-2021年整个日历年每个患者年的年利用率。ae通过术后基于索赔的治疗干预来定义。使用广义估计方程（GEE）对年龄、性别和日历年进行调整，评估通畅囊检查与sbce相关ae之间的关系。结果：在19,881例符合条件的克罗恩病患者中，确定了4,657例BAE和2,679例SBCE手术。模式转换不常见，83.9%≥2次检查的患者（n = 1683）在第二次检查时接受了相同的模式。随着时间的推移，这两种方式的使用率都在增加，从2013年到2021年，SBCE前的通畅胶囊检查增加了。有通畅胶囊检查的患者与没有通畅胶囊检查的患者相比，sbce相关的ae很少发生（0.88% vs. 1.47%）。在主要的GEE分析中，开放囊检查与sbce相关ae的较低几率没有独立关联（调整后的优势比为0.62；95%可信区间为0.28-1.37；P= 0.235），敏感性分析的结果也类似。结论：随着开放囊检查的普及，BAE和SBCE的使用在日本有所增加。总体而言，sbce相关的ae并不常见，在进行通畅性评估之前，其发生率较低。

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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来源期刊

Intestinal Research GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

7.40

自引率

10.20%

发文量

审稿时长

38 weeks

期刊介绍： Intestinal Research (Intest Res) is the joint official publication of the Asian Organization for Crohn''s and Colitis (AOCC), Chinese Society of IBD (CSIBD), Japanese Society for IBD (JSIBD), Korean Association for the Study of Intestinal Diseases (KASID), Taiwan Society of IBD (TSIBD) and Colitis Crohn''s Foundation (India) (CCF, india). The aim of the Journal is to provide broad and in-depth analysis of intestinal diseases, especially inflammatory bowel disease, which shows increasing tendency and significance. As a Journal specialized in clinical and translational research in gastroenterology, it encompasses multiple aspects of diseases originated from the small and large intestines. The Journal also seeks to propagate and exchange useful innovations, both in ideas and in practice, within the research community. As a mode of scholarly communication, it encourages scientific investigation through the rigorous peer-review system and constitutes a qualified and continual platform for sharing studies of researchers and practitioners. Specifically, the Journal presents up-to-date coverage of medical researches on the physiology, epidemiology, pathophysiology, clinical presentations, and therapeutic interventions of the intestinal diseases. General topics of interest include inflammatory bowel disease, colon and small intestine cancer or polyp, endoscopy, irritable bowel syndrome and other motility disorders, infectious enterocolitis, intestinal tuberculosis, and so forth. The Journal publishes diverse types of academic materials such as editorials, clinical and basic reviews, original articles, case reports, letters to the editor, brief communications, perspective, statement or commentary, and images that are useful to clinicians and researchers.