The Rate of Hospitalization of Pregnant Women with Multiple Sclerosis in Poland.

Multiple sclerosis (MS) is most often diagnosed in women of childbearing age. Therefore, it is important to examine the impact of pregnancy on the course of MS and to enable patients to make decisions about motherhood based on reliable data. The main objective of this study was to assess the impact of pregnancy on the course of MS by comparing the frequency of MS-related hospitalizations during pregnancy and 40 weeks postpartum versus 40 weeks before pregnancy. We used administrative health claims to identify female patients with MS, their deliveries, and their MS-related hospital admissions and calculated the frequency of MS-related hospital admissions before, during, and after pregnancy. We observed that MS is diagnosed approximately three times less often during pregnancy than before or after pregnancy. The number of MS-related hospital admissions decreased during pregnancy, especially in the third trimester. In contrast with other studies, we did not observe an increased level of MS-related admissions postpartum. The number of hospitalizations reported with steroid injections and emergency department visits also decreased during pregnancy. Our results show that pregnancy has a protective effect on the course of MS.

Biologic treatment of inflammatory bowel disease in Poland, 2012-2020: nationwide data.

INTRODUCTION: The frequency of biologic drug treatment for Polish patients diagnosed with ulcerative colitis (UC) or Crohn disease (CD) has been insufficiently studied. OBJECTIVES: We aimed to analyze the use of biologic treatments among Polish patients suffering from inflammatory bowel diseases (IBDs). PATIENTS AND METHODS: We used administrative data collected by the National Health Fund (Narodowy Fundusz Zdrowia [NFZ]), Poland's sole public health care payer. IBD cases were defined as cases with at least 2 records assigned code K50 or K51 according to the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD­10) and either at least 2 reimbursed prescriptions for IBD drugs or intestinal surgery preceding the record. We identified IBD patients receiving biologic treatments reimbursed by the NFZ in the years 2012-2020. We assessed the percentages of patients receiving biologic treatments in terms of disease type, sex, age group, and place of residence. RESULTS: While 6.8% of Polish CD patients received biologic treatment in 2012, that figure reached 7.9% by 2020. Biologic treatments were given to 0.4% of UC patients in 2014, and 1.6% in 2020. Among patients with both CD and UC, significantly fewer women received biologic therapy than men. The highest percentages of patients receiving biologic treatment for CD and UC were found in the 10-19 age group, while patients over 70 were the adults most rarely treated with biologic drugs. CONCLUSIONS: We showed a growing use of biologic agents in the treatment of IBD in Poland. Womenreceive biologic treatment for IBD significantly less frequently than men. The pediatric population features the highest proportion of patients receiving such treatment.

Nationwide data on epidemiology of inflammatory bowel disease in Poland between 2009 and 2020.

INTRODUCTION: The epidemiology of inflammatory bowel disease (IBD) in Poland has been recognized to only a limited extent. OBJECTIVES: We aimed to estimate the prevalence and incidence of IBD by analyzing data from the National Health Fund, Poland's sole public health insurer. PATIENTS AND METHODS: Administrative health claims collected over the 2009-2020 period were used to identify patients with Crohn's disease (CD) or ulcerative colitis (UC). A definition of a case comprised at least 2 records assigned K50 or K51 codes, plus at least 2 prescriptions for IBD drugs reimbursed, or else intestinal surgery preceding the record. The crude and European age­ standardized rates (EASR) and 95% CIs were calculated for prevalence and incidence. Time trends were also analyzed. RESULTS: As of 2020, there were 23 574 patients with CD and 73 235 with UC. The CD and UC prevalence was respectively 61.6 (EASR 60.3) and 191.4 (EASR 187.85) per 100 000. The prevalence of CD and UC was higher in men (64.1; EASR 61.3 and 201.4; EASR 202.7, respectively) than in women (59.3; EASR 58.4 and 182.0; EASR 175.5, respectively). The incidence of CD was 4.7 per 100 000 (EASR 4.6), and that of UC 12.5 (EASR 12.3). Through the period 2012-2018, the prevalence of both conditions was rising, even though downward trends were noted for the disease incidence. CONCLUSIONS: The prevalence and incidence of IBD in Poland are presented, with time trends showing a substantial increase in the disease burden over the years 2009-2020.

Gender-Related Differences in Prodromal Multiple Sclerosis Characteristics: A 7-Year Observation Study.

Increasing evidence supports the observation that multiple sclerosis (MS) has a preclinical period, with various prodromal signs and symptoms more frequently represented in patients with confirmed MS many years later. Considering the apparent gender differences in the incidence and clinical course of MS, it remains unclear whether it could be reflected in prodromal symptom features. This study aimed to compare a broad spectrum of prodromal signs and symptoms between males and females in the 7-year period before the definite diagnosis of MS. Data came from the central register of the national payer of services, financed under the public healthcare system in Poland. They covered a 7-year period of patient health record claims, from 2009 to 2016. The following groups of symptoms were significant with women: musculoskeletal (p < 0.001), ophthalmic (p < 0.001), laryngological (p < 0.001), digestive system (p < 0.001), urinary tract (p < 0.001), mental (p < 0.001), cardiovascular (p < 0.001), complaints and headaches (p < 0.001). There was also a weak correlation with head injuries (p = 0.03) while dermatological and reproductive system complaints did not appear to be significant (p < 0.05). For males, the following groups of symptoms were significant: musculoskeletal (p < 0.001), ophthalmic (p < 0.001), laryngological (p = 0.007), cardiovascular system symptoms (p < 0.001), and headaches (p < 0.001). Interestingly, reproductive system problems were overrepresented in the male population (p = 0.008). There was no significant correlation with MS risk for dermatological, digestive, urinary, and mental complaints. Similarly, head injuries were not significant. Our results shed more light on well-known differences in the epidemiological and clinical characteristics between sexes in multiple sclerosis, and show differences in prodromal complaints before MS onset.

Multiple sclerosis incidence and prevalence in Poland: Data from administrative health claims.

BACKGROUND: The detailed data concerning multiple sclerosis (MS) epidemiology in Poland are based on studies from few and less populated provinces. Therefore, we evaluated MS incidence and prevalence in Poland using electronic administrative health claims (AHCs) from the National Health Fund. METHODS: We retrospectively analyzed the AHC financial database collected from 2009 to 2019, encompassing all patients using public health resources. Three different algorithms for identification of MS cases were used: based on studies performed in German population (type 1), tested in the United States (type 2), and one created for the purpose of this study (type 3) that required at least 3 AHCs since 2009 with G35 ICD-10 diagnosis in outpatient specialist care, during hospitalization, and/or at rehabilitation service in any combination within maximally 3 years between the first and the last AHC, and provided that at least one AHC was either in neurological outpatient care or during hospitalization at a neurological ward or prescription of disease-modifying therapy. The American algorithm (type 2) required 3 AHCs within the analyzed year, while the German algorithm (type 1) required only one AHC in the analyzed year. RESULTS: According to the type 3 algorithm, age-adjusted MS incidence and prevalence in 2019 was 6.6 and 131.2 / 100,000 inhabitants, respectively. From 2014 to 2019, the significant trend in increasing prevalence and decreasing incidence of MS was observed (p<0.001). Median age of prevalent MS patients was 50 years (interquartile range, IQR 39-61) whereas median age of incident MS cases was 37 years (IQR 28-48). Female-to-male ratio in MS patients was 2.4. According to the type 1 algorithm, age-adjusted MS incidence and prevalence in 2019 was 11.6 and 244.9 / 100,000 inhabitants, respectively. Use of the type 2 algorithm resulted in estimated age-adjusted MS incidence and prevalence values in 2019 of 6.2 and 120.1 / 100,000 inhabitants, respectively. CONCLUSIONS: Multiple sclerosis incidence and prevalence in Poland are higher than previously reported and similar to the numbers shown for central European countries.