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Prevalence,phenotype and medication for the pediatric inflammatory bowel disease population of a state in Southeastern Brazil

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World Journal of Clinical Pediatrics 2022年第4期11卷 341-350页

作者： adalberta lima martins Renata de SáBrito Fróes Maria da Penha Zago-Gomes Pharmaceutical Assistance Health Department of Espírito SantoVitoria 29052-210Espírito SantoBrazil Department of Gastroenterology GastromedRio de Janeiro 22640-100Rio de JaneiroBrazil Departament of Medical Clinical Hospital Universitário Cassiano Antonio MoraesVitoria 29042-755Espírito SantoBrazil

BACKGROUND Inflammatory bowel disease(IBD)can lead to social and economic impacts *** Brazil,where its adult prevalence is increasing,the epidemiology of the pediatric population is not well known,although there is a documented increase in pediatric IBD incidence *** has continental dimensions,and Espírito Santo is a state of southeastern Brazil,the region with the highest demographic densities and is the economically most important in the *** To assess the prevalence,incidence,phenotype and medications in a Southeastern Brazilian pediatric *** Data were retrieved from the Public Medication-Dispensing System of the Department of Health in Espírito Santo state from documentation required to have access to highly expensive medication from August 1,2012 to July 31,*** were 1048 registered patients with IBD of all ages,and of these patients,the cases≤17 years were *** data were obtained through the analysis of administrative requests for these medications and included medical reports,endoscopy exams,histopathology and imaging tests,which followed the Clinical Protocols and Therapeutic Guidelines of the Brazilian *** confirmed cases of IBD were included in the *** There were 55 pediatric patients/1048 registered patients(5.34%),with Crohn's disease(CD)representing 30/55(55%),ulcerative colitis(UC)24/55(43.6%)and 1 unclassified IBD,a significant difference from adult patients(P=0.004).The prevalence of IBD in pediatric patients was 5.02 cases/100.000 inhabitants;the incidence in 2014 was 1.36 cases/100.000 *** mean age at diagnosis was 12.2 years(±4.2).There were 7 children diagnosed up to 6 years old,7 between 7 to 10 years old and 41 between 11 and≤17 years *** was no difference in the distribution of UC and CD between these age categories(P=0.743).There was no difference in gender distribution in relation to *** and adolescents with UC had a predominance of

关键词： Inflammatory bowel disease Pediatric Prevalence Phenotype Brazil

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Intestinal complications in Brazilian patients with ulcerative colitis treated with conventional therapy between 2011 and 2020

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World Journal of Gastroenterology 2023年第8期29卷 1330-1343页

作者： adalberta lima martins Rodrigo Galhardi Gasparini Ligia Yukie Sassaki Rogerio Saad-Hossne Alessandra Mileni Versut Ritter Tania Biatti Barreto Taciana Marcolino Claudia Yang Santos Espirito Santo Health Office State Office for Pharmaceutical AssistanceEspirito Santos 29056-030Brazil Department of Gastroenterology Specialized Medical CenterMarília 17502-020Brazil Department of Gastroenterology Sao Paulo State UniversityMedical SchoolBotucatu 18618-687Brazil Real World Evidence IQVIA BrazilSao Paulo 04719-002Brazil Department of Gastroenterology Takeda Pharmaceuticals BrazilSao Paulo 04794-000Brazil

BACKGROUND This was an observational, descriptive, and retrospective study from 2011 to 2020 from the Department of Informatics of the Brazilian Healthcare System *** To describe the intestinal complications(IC) of patients with ulcerative colitis(UC) who started conventional therapies in Brazil’s public Healthcare *** Patients ≥ 18 years of age who had at least one claim related to UC 10th revision of the International Statistical Classification of Diseases and Related Health Problems(ICD-10) code and at least 2 claims for conventional therapies were included. IC was defined as at least one claim of: UC-related hospitalization, procedures code for rectum or intestinal surgeries, and/or associated disease defined by ICD-10 codes(malignant neoplasia of colon, stenosis, hemorrhage, ulcer and other rectum or anus disease, megacolon, functional diarrhea volvulus, intussusception and erythema nodosum). Descriptive statistics, annual incidence, and incidence rate(IR) [per 100 patient-years(PY)] over the available follow-up period were *** In total, 41229 UC patients were included(median age, 48 years;65% women) and the median(interquartile range) follow-up period was 3.3(1.8-5.3) years. Conventional therapy used during follow-up period included: mesalazine(87%), sulfasalazine(15%), azathioprine(16%) or methotrexate(1%) with a median duration of 1.9(0.8-4.0) years. Overall IR of IC was 3.2 cases per 100 PY. Among the IC claims, 54% were related to associated diseases, 20% to procedures and 26% to hospitalizations. The overall annual incidence of IC was 2.9%, 2.6% and 2.5% in the first, second and third year after the first claim for therapy(index date), respectively. Over the first 3 years, the annual IR of UC-related hospitalizations ranged from 0.8% to 1.1%;associated diseases from 0.9% to 1.2%-in which anus or rectum disease, and malignant neoplasia of colon were the most frequently reported;and procedure events from 0.6% to 0.7%, bein

关键词： Ulcerative colitis Brazil Conventional therapy Intestinal complications Real world Public healthcare

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Intestinal complications in patients with Crohn's disease in the Brazilian public healthcare system between 2011 and 2020

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World Journal of Clinical Cases 2023年第14期11卷 3224-3237页

作者： Ligia Yukie Sassaki adalberta lima martins Rodrigo Galhardi-Gasparini Rogerio Saad-Hossne Alessandra Mileni Versut Ritter Tania Biatti Barreto Taciana Marcolino Bruno Balula Claudia Yang-Santos Department of Internal Medicine São Paulo State University-UNESPMedical School18618687BotucatuBrazil Department of Gastroenterology State Office for Pharmaceutical Assistance at Espírito Santo Health OfficeVitoria 29017-010Espirito SantoBrazil Department of Gastroenterology SETE–Specialized Medical CenterMarilia 17502-020Sao PauloBrazil Department of Surgery São Paulo State University-UNESPMedical School18618687BotucatuBrazil Real World Evidence IQVIA Brazil04719-002Sao PauloBrazil Medical Affairs Takeda Pharmaceuticals Brazil04794-000Sao PauloBrazil Clinical Research Takeda Pharmaceuticals Brazil04794-000Sao PauloBrazil

BACKGROUND This is a secondary database study using the Brazilian public healthcare system *** To describe intestinal complications(ICs)of patients in the Brazilian public healthcare system with Crohn’s disease(CD)who initiated and either only received conventional therapy(CVT)or also initiated anti-tumor necrosis factor(anti-TNF)therapy between 2011 and *** This study included patients with CD[international classification of diseases–10th revision(ICD-10):K50.0,K50.1,or K50.8](age:≥18 years)with at least one claim of CVT(sulfasalazine,azathioprine,mesalazine,or methotrexate).IC was defined as a CD-related hospitalization,pre-defined procedure codes(from rectum or intestinal surgery groups),and/or associated disease(pre-defined ICD-10 codes),and overall(one or more type of ICs).RESULTS In the 16809 patients with CD that met the inclusion criteria,the mean follow-up duration was 4.44(2.37)*** total,14697 claims of ICs were found from 4633 *** the 1-and 5-year of follow-up,8.3%and 8.2%of the patients with CD,respectively,presented at least one IC,of which fistula(31%)and fistulotomy(48%)were the most commonly *** overall incidence rate(95%CI)of ICs was 6.8(6.5–7.04)per 100 patient years for patients using only-CVT,and 9.2(8.8–9.6)for patients with evidence of anti-TNF *** The outcomes highlighted an important and constant rate of ICs over time in all the CD populations assessed,especially in patients exposed to anti-TNF *** outcome revealed insights into the real-world treatment and complications relevant to patients with CD and highlights that this disease remains a concern that may require additional treatment strategies in the Brazilian public healthcare system.

关键词： Crohn’s disease Intestinal complications Anti-tumor necrosis factor Conventional therapy Public healthcare system

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