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Dose Escalation of Biologics in Biologic-Naïve Patients With Ulcerative Colitis: Outcomes From the ODESSA-UC Study. 生物制剂在Biologic-Naïve溃疡性结肠炎患者中的剂量递增:来自ODESSA-UC研究的结果
IF 1.4
Crohn's & Colitis 360 Pub Date : 2023-11-16 eCollection Date: 2023-10-01 DOI: 10.1093/crocol/otad061
Sabyasachi Ghosh, Niranjan Kathe, Kandavadivu Umashankar, Kirti Mirchandani, Arunima Hait, Riyanka Paul, Ninfa Candela, Tao Fan
{"title":"Dose Escalation of Biologics in Biologic-Naïve Patients With Ulcerative Colitis: Outcomes From the ODESSA-UC Study.","authors":"Sabyasachi Ghosh, Niranjan Kathe, Kandavadivu Umashankar, Kirti Mirchandani, Arunima Hait, Riyanka Paul, Ninfa Candela, Tao Fan","doi":"10.1093/crocol/otad061","DOIUrl":"https://doi.org/10.1093/crocol/otad061","url":null,"abstract":"<p><strong>Background: </strong>Dose escalation of biologics may regain treatment response in patients with ulcerative colitis (UC). However, dose escalation rates and associated outcomes and costs are not well characterized in biologic-naïve patients receiving antitumor necrosis factor-alpha (anti-TNF-α) treatments, such as infliximab or adalimumab or vedolizumab.</p><p><strong>Methods: </strong>ODESSA-UC, a retrospective cohort study investigating dose escalation in patients with UC who had received first-line biologics, used data from IBM MarketScan databases. Adults with UC and ≥1 claim for an index drug (adalimumab, infliximab, or vedolizumab) were eligible. A Cox proportional hazards model was used to evaluate the adjusted rate of dose escalation. Logistic regression was used to evaluate the odds of experiencing adverse outcomes (corticosteroid use, infection, sepsis, or inflammatory bowel disease-related hospitalization) and incurring index drug costs.</p><p><strong>Results: </strong>A year after the start of maintenance, a lower proportion of patients experienced dose escalation with vedolizumab (22.3%) than adalimumab (43.0%). The dose escalation risk was significantly higher for infliximab (hazard ratio [HR], 1.894; 95% confidence interval [CI], 1.486-2.413) and adalimumab (HR, 2.120; 95% CI, 1.680-2.675) than for vedolizumab. The odds of experiencing an adverse outcome after dose escalation were higher for anti-TNF-α treatments than for vedolizumab (odds ratio, 2.052; 95% CI, 1.200-3.507). Index drug costs after dose escalation were lowest for vedolizumab.</p><p><strong>Conclusions: </strong>Patients with UC receiving vedolizumab had a lower risk of dose escalation and lower subsequent costs than patients receiving anti-TNF-α treatments. Our study demonstrates the possible clinical and economic implications of dose escalation.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10653026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138458458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ethnic Variation Trends in the Use of Ileal Pouch-Anal Anastomosis in Patients With Ulcerative Colitis. 溃疡性结肠炎患者回肠袋-肛门吻合术应用的民族差异趋势。
IF 1.4
Crohn's & Colitis 360 Pub Date : 2023-11-16 eCollection Date: 2023-10-01 DOI: 10.1093/crocol/otad072
Jana G Hashash, Fadi H Mourad, Tarek Odah, Francis A Farraye, Paul Kroner, Luca Stocchi
{"title":"Ethnic Variation Trends in the Use of Ileal Pouch-Anal Anastomosis in Patients With Ulcerative Colitis.","authors":"Jana G Hashash, Fadi H Mourad, Tarek Odah, Francis A Farraye, Paul Kroner, Luca Stocchi","doi":"10.1093/crocol/otad072","DOIUrl":"10.1093/crocol/otad072","url":null,"abstract":"<p><strong>Background: </strong>Approximately 15%-20% of patients with ulcerative colitis (UC) will require surgery during their lifetime. Ileal pouch-anal anastomosis (IPAA) is the preferred surgical option, which typically requires access to a specialist experienced in surgery for inflammatory bowel diseases (IBD).</p><p><strong>Methods: </strong>The aims of this study are the assessment of the comparative use of IPAA for UC among different racial/ethnic groups and observe trends over the past decade in the United States as well as the comparative assessment of their respective postoperative outcomes. This was an observational retrospective study using the National Inpatient Sample (NIS) 2009-2018 dataset. All patients with ICD-9/10CM codes for UC were included. The primary outcome was comparative trends in IPAA construction across races/ethnicities in the past decade, which was compared to White patients as reference. Multivariate regression analyses were used to adjust for age, gender, Charlson comorbidity index, income in patient zip code, insurance status, hospital region, location, size, and teaching status.</p><p><strong>Results: </strong>The number of patients discharged from US hospitals with an associated diagnosis of UC increased between 2009 and 2018, but the number of patients undergoing an IPAA decreased during that time period. Of 1 153 363 admissions related to UC, 60 688 required surgery for UC, of whom 16 601 underwent IPAA in the study period. Of all the patients undergoing surgery for UC, 2862 (4.7%) were Black, while 44 351 were White. This analysis indicated that Black patients were less likely to undergo IPAA both in 2009 and in 2018 compared to Whites. Hispanic patients were significantly less likely to receive IPAA in 2009 but were no longer less likely to receive IPAA in 2018 when compared to Whites.</p><p><strong>Conclusions: </strong>The use of IPAA among Black patients requiring surgery for UC remains less common than amongst their White counterparts. Further research is needed to determine if racial disparity is a factor in decreased access to specialized care.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10686008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138458459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Patients' Perspectives, Experiences, and Concerns With Perianal Fistulae: Insights From Online Targeted-Disease Forums. 患者对肛周瘘的看法、经历和关注:来自在线靶向疾病论坛的见解。
IF 1.4
Crohn's & Colitis 360 Pub Date : 2023-11-15 eCollection Date: 2023-10-01 DOI: 10.1093/crocol/otad073
Carine Khalil, Welmoed K van Deen, Taylor Dupuy, Gaurav Syal, Corey Arnold, Susan E Cazzetta, Pradeep P Nazarey, Christopher V Almario, Brennan M R Spiegel
{"title":"Patients' Perspectives, Experiences, and Concerns With Perianal Fistulae: Insights From Online Targeted-Disease Forums.","authors":"Carine Khalil, Welmoed K van Deen, Taylor Dupuy, Gaurav Syal, Corey Arnold, Susan E Cazzetta, Pradeep P Nazarey, Christopher V Almario, Brennan M R Spiegel","doi":"10.1093/crocol/otad073","DOIUrl":"10.1093/crocol/otad073","url":null,"abstract":"<p><strong>Background: </strong>Perianal fistulae can undermine physical, emotional, and social well-being in patients with Crohn's disease and are challenging to manage. Social media offers a rich opportunity to gain an in-depth understanding of the impact of perianal fistulae on patients' daily lives outside of controlled environments. In this study, we conducted social media analytics to examine patients' experiences with perianal fistulae and assessed the impact of perianal fistulae on patients' behavior and overall well-being.</p><p><strong>Methods: </strong>We used a mixed-method approach to examine 119 986 publicly available posts collected from 10 Crohn's disease forums in the United States between January 01, 2010 and January 01, 2020. Discussions related to Crohn's perianal fistulae were retrieved. We randomly selected 700 posts and qualitatively analyzed them using an inductive thematic approach. We then applied a latent Dirichlet allocation probabilistic topic model to explore themes in an unsupervised manner on the collection of 119 986 posts.</p><p><strong>Results: </strong>In the qualitative analysis, 5 major themes were identified: (1) burden of perianal fistula; (2) challenges associated with treatment; (3) online information seeking and sharing; (4) patient experiences with treatments; and (5) patients' apprehension about treatments. In the quantitative analysis, the percentages of posts related to the major themes were (1) 20%, (2) 29%, (3) 66%, and (4) 28%, while the topic model did not identify theme 5.</p><p><strong>Conclusions: </strong>Social media reveals a dynamic range of themes governing patients' perspectives and experiences with Crohn's perianal fistulae. In addition to the biopsychosocial burden, patients frequently express dissatisfaction with current treatments and often struggle to navigate among available management options.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10693318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138476961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Acceptability criteria of precision medicine: Lessons from patients' experiences with the GUIDE-IBD trial regarding the use of mobile health technology 精准医疗的可接受性标准:GUIDE-IBD试验中患者使用移动医疗技术的经验教训
Crohn's & Colitis 360 Pub Date : 2023-11-08 DOI: 10.1093/crocol/otad068
Anke Erdmann, Florian Schrinner, Christoph Rehmann-Sutter, Andre Franke, Ursula Seidler, Stefan Schreiber, Claudia Bozzaro
{"title":"Acceptability criteria of precision medicine: Lessons from patients' experiences with the GUIDE-IBD trial regarding the use of mobile health technology","authors":"Anke Erdmann, Florian Schrinner, Christoph Rehmann-Sutter, Andre Franke, Ursula Seidler, Stefan Schreiber, Claudia Bozzaro","doi":"10.1093/crocol/otad068","DOIUrl":"https://doi.org/10.1093/crocol/otad068","url":null,"abstract":"Abstract Background Research about mobile health technologies for IBD reveals that these devices are mainly used to predict or self-report disease activity. However, in the near future these tools can be used to integrate large data sets into machine learning for the development of personalized treatment algorithms. The impact of these technologies on patients’ wellbeing and daily lives has not yet been investigated. Methods We conducted 10 qualitative interviews with patients who used the XXXX mHealth technology. This is a special smartphone app for patients to record patient reported outcomes and a wearable to track physical activity, heart rate, and sleep quality. For data analysis, we used interpretative phenomenological analysis (IPA). This method is ideally suited for studying people’s lived experiences. Results The analysis of the data revealed 11 themes that were mentioned by at least 3 participants. These themes were: Self-tracking with wearable devices as normality; variable value of the data from the wearable; risk of putting people under pressure; stimulus to reflect about their own well-being and illness; risk of psychological distress; discussion about app data in the medical consultation is very brief or nonexistent; easier to be honest with an app than with a doctor; questionnaires do not always adequately capture the patient's condition; need for support; and the possibility to look at the data retrospectively. Conclusions Patients identified benefits, risks, and potentials for improvement, which should be considered in the further development of the devices and patient reported outcome scales, and in the implementation in usual care.","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135430059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mirikizumab Improves Quality of Life in Patients With Moderately-to-Severely Active Ulcerative Colitis: Results From the Phase 3 LUCENT-1 Induction and LUCENT-2 Maintenance Studies Mirikizumab改善中至重度活动性溃疡性结肠炎患者的生活质量:来自LUCENT-1诱导和LUCENT-2维持研究的3期结果
Crohn's & Colitis 360 Pub Date : 2023-11-07 DOI: 10.1093/crocol/otad070
Bruce E Sands, Brian G Feagan, Theresa Hunter Gibble, Kristina A Traxler, Nathan Morris, William J Eastman, Stefan Schreiber, Vipul Jairath, Millie D Long, Alessandro Armuzzi
{"title":"Mirikizumab Improves Quality of Life in Patients With Moderately-to-Severely Active Ulcerative Colitis: Results From the Phase 3 LUCENT-1 Induction and LUCENT-2 Maintenance Studies","authors":"Bruce E Sands, Brian G Feagan, Theresa Hunter Gibble, Kristina A Traxler, Nathan Morris, William J Eastman, Stefan Schreiber, Vipul Jairath, Millie D Long, Alessandro Armuzzi","doi":"10.1093/crocol/otad070","DOIUrl":"https://doi.org/10.1093/crocol/otad070","url":null,"abstract":"Abstract Background Mirikizumab, an anti-IL-23p19 antibody, demonstrated efficacy in phase 3, randomized, double-blind, placebo-controlled LUCENT-1 (induction/NCT03518086) and LUCENT-2 (maintenance/NCT03524092) ulcerative colitis (UC) studies. We evaluated the effect of mirikizumab on quality of life (QoL) outcomes in these studies. Methods In LUCENT-1, 1162 patients with moderately-to-severely active UC were randomized 3:1 to receive mirikizumab 300mg intravenous or placebo every 4 weeks (Q4W) for 12 weeks. In LUCENT-2, mirikizumab induction responders (N=544) were re-randomized 2:1 to receive mirikizumab 200mg subcutaneous or placebo Q4W through Week (W) 40 (W52 of treatment). QoL was assessed at W12 and W52 using patient-reported outcomes. Treatments were statistically compared using analysis of covariance model (continuous outcomes) and Cochran-Mantel-Haenszel test (binary outcomes). Results At W12 and W52, mirikizumab showed significant improvement in Inflammatory Bowel Disease Questionnaire (IBDQ) total and domain scores (p&amp;lt;0.001); 36-Item Short Form Health Survey (SF-36) Physical Component Summary (PCS), Mental Component Summary (MCS), and domain scores (p&amp;lt;0.05); EQ-5D-5L scores (p&amp;lt;0.001); Work Productivity and Activity Impairment Questionnaire (UC) scores (p&amp;lt;0.05); Patient Global Rating of Severity (p&amp;lt;0.001); and Patient Global Rating of Change (p&amp;lt;0.01) scores. Significantly higher proportion of mirikizumab-treated patients achieved IBDQ response (W12: 72.7% vs 55.8%; W52: 79.2% vs 49.2%; p&amp;lt;0.001), IBDQ remission (W12: 57.5% vs 39.8%; W52: 72.3% vs 43.0%; p&amp;lt;0.001), and clinically important improvements in PCS (W12: 50.6% vs 41.5%; W52: 61.9% vs 36.9%; p&amp;lt;0.05) and MCS (W12: 44.2% vs 37.8%; W52: 51.2% vs 34.6%; p&amp;lt;0.05) scores. Conclusions Mirikizumab improved QoL in patients with moderately-to-severely active UC in phase 3 LUCENT-1 and LUCENT-2 studies.","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135540540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Training Pearl: Welcome to the CC360 Fellow's Corner. 训练珍珠:欢迎来到CC360会员角。
IF 1.4
Crohn's & Colitis 360 Pub Date : 2023-10-27 eCollection Date: 2023-10-01 DOI: 10.1093/crocol/otad060
Hilary K Michel, Lisa Malter
{"title":"Training Pearl: Welcome to the CC360 Fellow's Corner.","authors":"Hilary K Michel,&nbsp;Lisa Malter","doi":"10.1093/crocol/otad060","DOIUrl":"https://doi.org/10.1093/crocol/otad060","url":null,"abstract":"<p><p>The Crohn's & Colitis Foundation has grown to appreciate the needs of gastroenterology trainees with numerous initiatives designed to provide education, academic opportunities, and mentoring in inflammatory bowel disease (IBD) in recent years. The editors and staff at <i>Crohn's and Colitis 360</i> (CC360) have launched 2 new initiatives, the Fellow's Corner and the CC360 Editorial Fellowship, to support trainees in gaining knowledge and skills regarding peer review and publication as well as offering guidance on training in IBD and an opportunity for publication in this peer-reviewed, open access, quarterly online journal. These opportunities are described in this manuscript.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10622168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71491091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Thiopurine Exposure During Pregnancy is Not Associated With Anemia in Infants Born to Mothers With IBD. 妊娠期接触硫嘌呤与IBD母亲所生婴儿的贫血无关。
IF 1.4
Crohn's & Colitis 360 Pub Date : 2023-10-27 eCollection Date: 2023-10-01 DOI: 10.1093/crocol/otad066
Fiona Yeaman, Amelie Stritzke, Verena Kuret, Nastaran Sharifi, Cynthia H Seow, Amy Metcalfe, Yvette Leung
{"title":"Thiopurine Exposure During Pregnancy is Not Associated With Anemia in Infants Born to Mothers With IBD.","authors":"Fiona Yeaman, Amelie Stritzke, Verena Kuret, Nastaran Sharifi, Cynthia H Seow, Amy Metcalfe, Yvette Leung","doi":"10.1093/crocol/otad066","DOIUrl":"10.1093/crocol/otad066","url":null,"abstract":"<p><strong>Background: </strong>Thiopurines are commonly used to treat inflammatory bowel disease (IBD). Thiopurines are considered safe throughout pregnancy. However, a published study suggested the risk of neonatal anemia was increased if exposed to thiopurines in utero. This prospective cohort study aimed to determine if there is an increased risk of cytopenia among infants born to pregnant people with IBD, exposed or unexposed to thiopurines, compared to infants born to those without IBD.</p><p><strong>Methods: </strong>Pregnant IBD patients, with and without thiopurine exposure, and one cohort of control individuals were recruited over a 5-year period. Consenting individuals completed a questionnaire and infants had a complete blood cell count at the newborn heel prick. Anemia was defined as hemoglobin (Hb) < 140g/L. Descriptive statistics were used to characterize the study population. Fisher exact tests were used to examine differences in outcomes between groups, a <i>P-</i>value of < 0.05 was deemed significant.</p><p><strong>Results: </strong>Three cohorts were recruited: 19 IBD patients on thiopurines, 50 IBD patients not on thiopurines, and 37 controls (total of 106). Neonatal median Hb was not different with 177g/L (IQR 38g/L) for the IBD thiopurine group, 180.5g/L (IQR 40g/L) for the IBD non-thiopurine group, and 181g/L (IQR 37g/L) for the controls. Nineteen infants (18%) were cytopenic with 12 (11%) anemic, 6 (5.6%) thrombocytopenic, and 1 (0.94%) lymphopenic. Thiopurine exposure was only in one, mildly anemic, infant.</p><p><strong>Conclusions: </strong>These findings further support physicians and IBD patients contemplating pregnancy that current guidelines recommending thiopurine adherence do not lead to increased perinatal risk of anemia or cytopenia.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10629965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71520773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Providing Pneumococcal Vaccines Reduces the Risk of Serious Infections From Pneumococcal Pneumonia. We Should Consider a Simplified Immunization Schedule. 提供肺炎球菌疫苗可降低肺炎球菌肺炎引起严重感染的风险。我们应该考虑简化免疫计划。
IF 1.8
Crohn's & Colitis 360 Pub Date : 2023-10-27 eCollection Date: 2023-10-01 DOI: 10.1093/crocol/otad056
Mazen Almasry, Freddy Caldera
{"title":"Providing Pneumococcal Vaccines Reduces the Risk of Serious Infections From Pneumococcal Pneumonia. We Should Consider a Simplified Immunization Schedule.","authors":"Mazen Almasry, Freddy Caldera","doi":"10.1093/crocol/otad056","DOIUrl":"10.1093/crocol/otad056","url":null,"abstract":"","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10610748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71411058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessing the Impact of the COVID-19 Pandemic on the Severity of Pediatric Inflammatory Bowel Disease Admissions and New Diagnoses. 评估新冠肺炎大流行对儿科炎症性肠病入院和新诊断严重程度的影响。
IF 1.4
Crohn's & Colitis 360 Pub Date : 2023-10-25 eCollection Date: 2023-10-01 DOI: 10.1093/crocol/otad062
Malika Waschmann, Ariana Stuart, Kimberly Trieschmann, Henry C Lin, Anna K Hunter
{"title":"Assessing the Impact of the COVID-19 Pandemic on the Severity of Pediatric Inflammatory Bowel Disease Admissions and New Diagnoses.","authors":"Malika Waschmann, Ariana Stuart, Kimberly Trieschmann, Henry C Lin, Anna K Hunter","doi":"10.1093/crocol/otad062","DOIUrl":"10.1093/crocol/otad062","url":null,"abstract":"<p><strong>Introduction: </strong>The COVID-19 pandemic has introduced new challenges to the diagnosis and management of pediatric inflammatory bowel disease (IBD). Many patients have had only limited access to their providers through telemedicine, and many chose to delay nonemergent treatment.</p><p><strong>Methods: </strong>A retrospective chart review of patients with IBD seen by the Pediatric Gastroenterology Division at Doernbecher Children's Hospital from January 2018 to August 2021 was conducted. The study cohort was divided into 2 groups: those presenting before the onset of the COVID-19 pandemic (January 1, 2018 to February 28, 2020) and those presenting during the pandemic (March 1, 2020 to August 1, 2021). Variables collected included: age, sex, race, ethnicity, IBD type, insurance type, location of residence. Primary outcome measures selected focused on disease severity, initial type of treatment, or surgical intervention offered. A subgroup analysis of the new diagnosis patients was performed. Data were analyzed using independent <i>t</i>-tests, chi-squared analysis, and Wilcoxon rank sum tests.</p><p><strong>Results: </strong>Two hundred and eleven patients met inclusion criteria, 107 (72 new diagnoses, 35 admissions) within the pre-COVID epoch and 104 (67 new diagnoses, 37 admissions) within the during-COVID epoch. Patients in the during-COVID epoch had higher fecal calprotectin level and were more likely to be started on a biologic as initial treatment. Patients admitted during COVID for IBD flare were more likely to require surgical intervention. Subgroup analysis of newly diagnosed patients revealed higher incidence of comorbid depression and anxiety.</p><p><strong>Conclusions: </strong>Our review identified increased disease severity in newly diagnosed pediatric patients with IBD as well as pediatric patients admitted for flare during COVID. Increases in anxiety and depression rates during COVID may have contributed to worsened disease severity.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10629215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71520769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Knowledge and Attitude of Inflammatory Bowel Disease Patients Toward Colorectal Cancer Risk, Its Management, and the Role of Healthcare Providers: A Cross-Sectional Study in the UK. 炎症性肠病患者对结直肠癌癌症风险的认识和态度、管理和医疗保健提供者的作用:英国的一项跨部门研究。
IF 1.4
Crohn's & Colitis 360 Pub Date : 2023-10-24 eCollection Date: 2023-10-01 DOI: 10.1093/crocol/otad067
Fiza Khan, Christine Norton, Wladyslawa Czuber-Dochan
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