Sex-based differences in prescribed medications, surgical procedures and disease-related complications in IBD

Danese et al 1 emphasise the urgency to implement advanced combination treatments (ACTs) for inflammatory bowel disease (IBD), suggesting that ACTs may be particularly effective in certain patient populations. In this context, sex as a biological variable is paramount to consider, but remains understudied in all aspects of research reporting and analyses (referred to as ‘sex-aware’ analyses2), and represents an essential element when evaluating disease prevention, intervention(s) and precision medicine. This is especially applicable to IBD since increasing evidence supports sex-based differences, including response to treatment(s), between male and female patients living with Crohn’s disease (CD) or ulcerative colitis (UC),3 4 yet specific studies to date are sparse. To this end, we sought to determine the current state of sex disparities in prescribed medications, surgical interventions and disease-related complications in IBD. Using the TriNetX platform, which allows real-time access to deidentified electronic health records of over 116 million patients, we performed a retrospective, sex-aware cohort study on 2 July 2024, implementing a previously described approach5 (validated with a positive predictive value of ≥92%).6 We identified over 359 426 patients having an index event of at least two instances of the same CD/UC diagnosis, with an added ≥2 instances of drug/therapy when considering outcomes. These patient groups were divided by sex and the resulting …