Decreasing trends in hospitalizations during anti-TNF therapy are associated with time to anti-TNF therapy: Results from two referral centres.
Dig Liver Dis
; 46(11): 985-90, 2014 Nov.
Article
em En
| MEDLINE
| ID: mdl-25156871
ABSTRACT
BACKGROUND:
Hospitalization is an important outcome measure and a major driver of costs in patients with inflammatory bowel disease. We analysed medical and surgical hospitalization rates and predictors of hospitalization before and during anti-TNF therapy.METHODS:
Data from 194 consecutive patients were analysed retrospectively (males, 45.4%, median age at diagnosis, 24.0 years, infliximab/adalimumab 144/50) in whom anti-TNF therapy was started after January 1, 2008. Total follow-up was 1874 patient-years and 474 patient-years with anti-TNF exposure.RESULTS:
Hospitalization rates hospitalization decreased only in Crohn's disease (odds ratio 0.59, 95% confidence interval 0.51-0.70, median 2-years' anti-TNF exposure) with a same trend for surgical interventions (p=0.07), but not in ulcerative colitis. Need for hospitalization decreased in Crohn's disease with early (within 3-years from diagnosis, p=0.016 by McNemar test), but not late anti-TNF exposure. At logistic regression analysis complicated disease behaviour (p=0.03), concomitant azathioprine (p=0.02) use, but not anti-TNF type, gender, perianal disease or previous surgeries were associated with the risk of hospitalization during anti-TNF therapy.CONCLUSION:
Hospitalization rate decreased significantly in patients with Crohn's disease but not ulcerative colitis after the introduction of anti-TNF therapy and was associated with time to therapy. Complicated disease phenotype and concomitant azathioprine use were additional factors defining the risk of hospitalization.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Colite Ulcerativa
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Doença de Crohn
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Fator de Necrose Tumoral alfa
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Hospitalização
Idioma:
En
Ano de publicação:
2014
Tipo de documento:
Article