Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2026
Treatment and Outcomes of Crohn's Disease and Ulcerative Colitis in Newly Diagnosed Adults in the United States, 2007 to 2023.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Ahuja Dhruv, Park Soo-Kyung, Qi Yuchen, Patel Sagar B, Jairath Vipul, Xu Ronghui, Boland Brigid S, Lewis James D, Kappelman Michael D, Goodwin Shane W, Singh Siddharth
Аннотация
BACKGROUND & AIMS: We examined treatment and outcomes of inflammatory bowel diseases (IBDs) in a contemporary and diverse cohort of adults with newly diagnosed IBD in a large, commercially insured United States population.
METHODS: Using an administrative claims database (OptumLabs Data Warehouse), we created an inception cohort of physician-diagnosed IBD between 2007 and 2023. We examined cumulative incidence of hospitalization, surgery, safety events, and medication use in patients with Crohn's disease (CD) and ulcerative colitis (UC).
RESULTS: Among 3044 adults with newly diagnosed CD (age at diagnosis, 39 ± 15 years; 47% male; 83% White, 7.5% Black, and 7.1% Hispanic patients) followed over a mean 4.3 ± 3.1 years, 5-year risk of IBD-related hospitalization, major surgery, and serious infections was 16%, 12%, and 13%, respectively, with no consistent racial and ethnic, age, or sex differences. In patients diagnosed between 2019 and 2023, 1-year cumulative use of corticosteroids and advanced therapy was 44% (22% with ≥2 courses) and 53%, respectively, without significant racial and ethnic, age, or sex differences. Among 3893 patients with newly diagnosed UC (age at diagnosis, 41 ± 14 years; 52% male; 80% White, 7.2% Black, and 8.2% Hispanic patients) followed over 4.2 ± 3.0 years, 5-year risk of IBD-related hospitalization, colectomy, and serious infection was 11%, 6%, and 10%, respectively, with lower risk in Hispanic patients (vs White patients). In patients diagnosed between 2019 and 2023, 1-year cumulative use of corticosteroids and advanced therapy was 47% (26% with ≥2 courses) and 27%, respectively, with earlier initiation of advanced therapies in more recent time periods, and with lower utilization of advanced therapies in Hispanic patients.
CONCLUSIONS: In a contemporary and diverse cohort of commercially insured adults with newly diagnosed IBD in the United States, excess corticosteroid use is decreasing in recent era, along with early initiation of advanced therapies. No consistent racial and ethnic, age, or sex differences were identified.
METHODS: Using an administrative claims database (OptumLabs Data Warehouse), we created an inception cohort of physician-diagnosed IBD between 2007 and 2023. We examined cumulative incidence of hospitalization, surgery, safety events, and medication use in patients with Crohn's disease (CD) and ulcerative colitis (UC).
RESULTS: Among 3044 adults with newly diagnosed CD (age at diagnosis, 39 ± 15 years; 47% male; 83% White, 7.5% Black, and 7.1% Hispanic patients) followed over a mean 4.3 ± 3.1 years, 5-year risk of IBD-related hospitalization, major surgery, and serious infections was 16%, 12%, and 13%, respectively, with no consistent racial and ethnic, age, or sex differences. In patients diagnosed between 2019 and 2023, 1-year cumulative use of corticosteroids and advanced therapy was 44% (22% with ≥2 courses) and 53%, respectively, without significant racial and ethnic, age, or sex differences. Among 3893 patients with newly diagnosed UC (age at diagnosis, 41 ± 14 years; 52% male; 80% White, 7.2% Black, and 8.2% Hispanic patients) followed over 4.2 ± 3.0 years, 5-year risk of IBD-related hospitalization, colectomy, and serious infection was 11%, 6%, and 10%, respectively, with lower risk in Hispanic patients (vs White patients). In patients diagnosed between 2019 and 2023, 1-year cumulative use of corticosteroids and advanced therapy was 47% (26% with ≥2 courses) and 27%, respectively, with earlier initiation of advanced therapies in more recent time periods, and with lower utilization of advanced therapies in Hispanic patients.
CONCLUSIONS: In a contemporary and diverse cohort of commercially insured adults with newly diagnosed IBD in the United States, excess corticosteroid use is decreasing in recent era, along with early initiation of advanced therapies. No consistent racial and ethnic, age, or sex differences were identified.