Real-world disease activity and sociodemographic, clinical and treatment characteristics of moderate-to-severe inflammatory bowel disease in Brazil
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , , , , , , , , , , , , , , , , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNESP |
Texto Completo: | http://dx.doi.org/10.3748/WJG.V27.I2.208 http://hdl.handle.net/11449/207247 |
Resumo: | BACKGROUND Understanding the treatment landscape of inflammatory bowel diseases (IBD) is essential for improving disease management and patient outcomes. Brazil is the largest Latin American country, and it presents socioeconomic and health care differences across its geographical regions. This country has the highest increase in IBD incidence and prevalence in Latin America, but information about the clinical and treatment characteristics of IBD is scarce. AIM To describe the sociodemographic, clinical, and treatment characteristics of IBD outpatients in Brazil overall and in the Southeast, South and Northeast/Midwest regions. METHODS Multicenter, cross-sectional study with a 3-year retrospective chart review component. Patients with moderate-to-severe Crohn's disease (CD) or ulcerative colitis (UC) were consecutively enrolled between October 2016 and February 2017. Active CD at enrollment was defined as a Harvey Bradshaw Index ≥ 8 or a CD Activity Index ≥ 220 or a calprotectin level > 200 μg/g or an active result based on colonoscopy suggestive of inadequate control during the previous year; active UC was defined as a partial Mayo score ≥ 5. Descriptive statistics were used to analyze all variables. RESULTS In a total of 407 included patients, CD was more frequent than UC, both overall (264 CD/143 UC patients) and by region (CD:UC ratios of 2.1 in the Southeast, 1.6 in the South and 1.2 in the Northeast/Midwest). The majority of patients were female (54.2% of CD; 56.6% of UC), and the mean ages were 45.9 ± 13.8 years (CD) and 42.9 ± 13.0 years (UC). The median disease duration was 10.0 (range: 0.5-45) years for both IBD types. At enrollment, 44.7% [95% confidence interval (CI): 38.7-50.7] of CD patients and 25.2% (95%CI: 18.1-32.3) of UC patients presented with active disease. More than 95% of IBD patients were receiving treatment at enrollment; CD patients were commonly treated with biologics (71.6%) and immunosuppressors (67.4%), and UC patients were commonly treated with mesalazine [5-Aminosalicylic acid (5-ASA)] derivates (69.9%) and immunosuppressors (44.1%). More than 50% of the CD patients had ileocolonic disease, and 41.7% presented with stricturing disease. One-quarter of CD patients had undergone CD-related surgery in the past 3 years, and this proportion was lower in the Northeast/Midwest region (2.9%). CONCLUSION In Brazil, there are regional variations in IBD management. CD outweighs UC in both frequency and disease activity. However, one-quarter of UC patients have active disease, and most are receiving 5-ASA treatment. |
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Real-world disease activity and sociodemographic, clinical and treatment characteristics of moderate-to-severe inflammatory bowel disease in BrazilCrohn's diseaseDisease activityEpidemiologyInflammatory bowel diseaseTreatmentUlcerative colitisBACKGROUND Understanding the treatment landscape of inflammatory bowel diseases (IBD) is essential for improving disease management and patient outcomes. Brazil is the largest Latin American country, and it presents socioeconomic and health care differences across its geographical regions. This country has the highest increase in IBD incidence and prevalence in Latin America, but information about the clinical and treatment characteristics of IBD is scarce. AIM To describe the sociodemographic, clinical, and treatment characteristics of IBD outpatients in Brazil overall and in the Southeast, South and Northeast/Midwest regions. METHODS Multicenter, cross-sectional study with a 3-year retrospective chart review component. Patients with moderate-to-severe Crohn's disease (CD) or ulcerative colitis (UC) were consecutively enrolled between October 2016 and February 2017. Active CD at enrollment was defined as a Harvey Bradshaw Index ≥ 8 or a CD Activity Index ≥ 220 or a calprotectin level > 200 μg/g or an active result based on colonoscopy suggestive of inadequate control during the previous year; active UC was defined as a partial Mayo score ≥ 5. Descriptive statistics were used to analyze all variables. RESULTS In a total of 407 included patients, CD was more frequent than UC, both overall (264 CD/143 UC patients) and by region (CD:UC ratios of 2.1 in the Southeast, 1.6 in the South and 1.2 in the Northeast/Midwest). The majority of patients were female (54.2% of CD; 56.6% of UC), and the mean ages were 45.9 ± 13.8 years (CD) and 42.9 ± 13.0 years (UC). The median disease duration was 10.0 (range: 0.5-45) years for both IBD types. At enrollment, 44.7% [95% confidence interval (CI): 38.7-50.7] of CD patients and 25.2% (95%CI: 18.1-32.3) of UC patients presented with active disease. More than 95% of IBD patients were receiving treatment at enrollment; CD patients were commonly treated with biologics (71.6%) and immunosuppressors (67.4%), and UC patients were commonly treated with mesalazine [5-Aminosalicylic acid (5-ASA)] derivates (69.9%) and immunosuppressors (44.1%). More than 50% of the CD patients had ileocolonic disease, and 41.7% presented with stricturing disease. One-quarter of CD patients had undergone CD-related surgery in the past 3 years, and this proportion was lower in the Northeast/Midwest region (2.9%). CONCLUSION In Brazil, there are regional variations in IBD management. CD outweighs UC in both frequency and disease activity. However, one-quarter of UC patients have active disease, and most are receiving 5-ASA treatment.Department of Internal Medicine Federal University of Rio de JaneiroDepartment of Surgery and Anatomy Ribeirão Preto Medical School University of São PauloDepartment of Internal Medicine São Paulo State University (UNESP) Medical SchoolIBD Unit Federal University of BahiaDepartment of Clinical Medicine Medical School Universidade Federal de Minas GeraisDepartment of Gastroenterology Escola Paulista de MedicinaHospital de Clinicas Universidade Federal do ParanaDepartment of Proctology Beneficencia Portuguesa Hospital Kaiser Day HospitalDepartment of Gastroenterology and Hepatology Sciences Hospital de Clínicas Universidade Federal do Rio Grande do SulDepartment of Gastroenterology Faculdade de Medicina do ABCDepartment of General Medicine Gastroenterology Unit University Hospital Federal University of PiauiDepartment of Gastroenterology Faculdade de Medicina Universidade Federal de GoiásDepartment of Surgery Botucatu Medical School São Paulo State University (UNESP)Department of Gastroenterology UNIFESPIBD Unit Gastroenterology Department Hospital Nossa Senhora das GraçasDepartment of Proctology Kaiser Hospital DiaHealth Sciences Center Epidemiology Unit State University of PiauiDepartment of Gastroenterology CMIP Centro Mineiro de PesquisaScientific Affairs Takeda Pharmaceuticals BrazilClinical Research Takeda Pharmaceuticals BrazilDepartment of Medicine University Hospital of Federal University of Juiz de ForaDepartment of Internal Medicine São Paulo State University (UNESP) Medical SchoolDepartment of Surgery Botucatu Medical School São Paulo State University (UNESP)Federal University of Rio de JaneiroUniversidade de São Paulo (USP)Universidade Estadual Paulista (Unesp)Universidade Federal da Bahia (UFBA)Universidade Federal de Minas Gerais (UFMG)Escola Paulista de MedicinaUniversidade Federal do ParanaKaiser Day HospitalUniversidade Federal do Rio Grande do SulFaculdade de Medicina do ABCFederal University of PiauiUniversidade Federal de Goiás (UFG)Universidade Federal de São Paulo (UNIFESP)Hospital Nossa Senhora das GraçasKaiser Hospital DiaState University of PiauiCMIP Centro Mineiro de PesquisaTakeda Pharmaceuticals BrazilUniversity of Juiz de ForaZaltman, CyrlaParra, Rogério SerafimSassaki, Ligia Yukie [UNESP]Santana, Genoile Oliveirade Lourdes Abreu Ferrari, MariaMiszputen, Sender J.Amarante, Heda M.B.S.Kaiser, Roberto LuizFlores, CristinaCatapani, Wilson R.Parente, José Miguel LuzBafutto, MauroRamos, OderyGonçalves, Carolina D.Guimaraes, Isabella Mirandada Rocha, Jose J.R.Feitosa, Marley R.Feres, OmarSaad-Hossne, Rogerio [UNESP]Penna, Francisco Guilherme CancelaCunha, Pedro Ferrari SalesGomes, Tarcia N.F.Nones, Rodrigo BremerFaria, Mikaell Alexandre GouveaDias Parente, Mírian Perpétua PalhaScotton, António S.Caratin, Rosana FusaroSenra, JulianaChebli, Júlio Maria2021-06-25T10:51:56Z2021-06-25T10:51:56Z2021-01-14info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article208-223http://dx.doi.org/10.3748/WJG.V27.I2.208World Journal of Gastroenterology, v. 27, n. 2, p. 208-223, 2021.2219-28401007-9327http://hdl.handle.net/11449/20724710.3748/WJG.V27.I2.2082-s2.0-85100515563Scopusreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengWorld Journal of Gastroenterologyinfo:eu-repo/semantics/openAccess2024-08-14T17:36:53Zoai:repositorio.unesp.br:11449/207247Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462024-08-14T17:36:53Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false |
dc.title.none.fl_str_mv |
Real-world disease activity and sociodemographic, clinical and treatment characteristics of moderate-to-severe inflammatory bowel disease in Brazil |
title |
Real-world disease activity and sociodemographic, clinical and treatment characteristics of moderate-to-severe inflammatory bowel disease in Brazil |
spellingShingle |
Real-world disease activity and sociodemographic, clinical and treatment characteristics of moderate-to-severe inflammatory bowel disease in Brazil Zaltman, Cyrla Crohn's disease Disease activity Epidemiology Inflammatory bowel disease Treatment Ulcerative colitis |
title_short |
Real-world disease activity and sociodemographic, clinical and treatment characteristics of moderate-to-severe inflammatory bowel disease in Brazil |
title_full |
Real-world disease activity and sociodemographic, clinical and treatment characteristics of moderate-to-severe inflammatory bowel disease in Brazil |
title_fullStr |
Real-world disease activity and sociodemographic, clinical and treatment characteristics of moderate-to-severe inflammatory bowel disease in Brazil |
title_full_unstemmed |
Real-world disease activity and sociodemographic, clinical and treatment characteristics of moderate-to-severe inflammatory bowel disease in Brazil |
title_sort |
Real-world disease activity and sociodemographic, clinical and treatment characteristics of moderate-to-severe inflammatory bowel disease in Brazil |
author |
Zaltman, Cyrla |
author_facet |
Zaltman, Cyrla Parra, Rogério Serafim Sassaki, Ligia Yukie [UNESP] Santana, Genoile Oliveira de Lourdes Abreu Ferrari, Maria Miszputen, Sender J. Amarante, Heda M.B.S. Kaiser, Roberto Luiz Flores, Cristina Catapani, Wilson R. Parente, José Miguel Luz Bafutto, Mauro Ramos, Odery Gonçalves, Carolina D. Guimaraes, Isabella Miranda da Rocha, Jose J.R. Feitosa, Marley R. Feres, Omar Saad-Hossne, Rogerio [UNESP] Penna, Francisco Guilherme Cancela Cunha, Pedro Ferrari Sales Gomes, Tarcia N.F. Nones, Rodrigo Bremer Faria, Mikaell Alexandre Gouvea Dias Parente, Mírian Perpétua Palha Scotton, António S. Caratin, Rosana Fusaro Senra, Juliana Chebli, Júlio Maria |
author_role |
author |
author2 |
Parra, Rogério Serafim Sassaki, Ligia Yukie [UNESP] Santana, Genoile Oliveira de Lourdes Abreu Ferrari, Maria Miszputen, Sender J. Amarante, Heda M.B.S. Kaiser, Roberto Luiz Flores, Cristina Catapani, Wilson R. Parente, José Miguel Luz Bafutto, Mauro Ramos, Odery Gonçalves, Carolina D. Guimaraes, Isabella Miranda da Rocha, Jose J.R. Feitosa, Marley R. Feres, Omar Saad-Hossne, Rogerio [UNESP] Penna, Francisco Guilherme Cancela Cunha, Pedro Ferrari Sales Gomes, Tarcia N.F. Nones, Rodrigo Bremer Faria, Mikaell Alexandre Gouvea Dias Parente, Mírian Perpétua Palha Scotton, António S. Caratin, Rosana Fusaro Senra, Juliana Chebli, Júlio Maria |
author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Federal University of Rio de Janeiro Universidade de São Paulo (USP) Universidade Estadual Paulista (Unesp) Universidade Federal da Bahia (UFBA) Universidade Federal de Minas Gerais (UFMG) Escola Paulista de Medicina Universidade Federal do Parana Kaiser Day Hospital Universidade Federal do Rio Grande do Sul Faculdade de Medicina do ABC Federal University of Piaui Universidade Federal de Goiás (UFG) Universidade Federal de São Paulo (UNIFESP) Hospital Nossa Senhora das Graças Kaiser Hospital Dia State University of Piaui CMIP Centro Mineiro de Pesquisa Takeda Pharmaceuticals Brazil University of Juiz de Fora |
dc.contributor.author.fl_str_mv |
Zaltman, Cyrla Parra, Rogério Serafim Sassaki, Ligia Yukie [UNESP] Santana, Genoile Oliveira de Lourdes Abreu Ferrari, Maria Miszputen, Sender J. Amarante, Heda M.B.S. Kaiser, Roberto Luiz Flores, Cristina Catapani, Wilson R. Parente, José Miguel Luz Bafutto, Mauro Ramos, Odery Gonçalves, Carolina D. Guimaraes, Isabella Miranda da Rocha, Jose J.R. Feitosa, Marley R. Feres, Omar Saad-Hossne, Rogerio [UNESP] Penna, Francisco Guilherme Cancela Cunha, Pedro Ferrari Sales Gomes, Tarcia N.F. Nones, Rodrigo Bremer Faria, Mikaell Alexandre Gouvea Dias Parente, Mírian Perpétua Palha Scotton, António S. Caratin, Rosana Fusaro Senra, Juliana Chebli, Júlio Maria |
dc.subject.por.fl_str_mv |
Crohn's disease Disease activity Epidemiology Inflammatory bowel disease Treatment Ulcerative colitis |
topic |
Crohn's disease Disease activity Epidemiology Inflammatory bowel disease Treatment Ulcerative colitis |
description |
BACKGROUND Understanding the treatment landscape of inflammatory bowel diseases (IBD) is essential for improving disease management and patient outcomes. Brazil is the largest Latin American country, and it presents socioeconomic and health care differences across its geographical regions. This country has the highest increase in IBD incidence and prevalence in Latin America, but information about the clinical and treatment characteristics of IBD is scarce. AIM To describe the sociodemographic, clinical, and treatment characteristics of IBD outpatients in Brazil overall and in the Southeast, South and Northeast/Midwest regions. METHODS Multicenter, cross-sectional study with a 3-year retrospective chart review component. Patients with moderate-to-severe Crohn's disease (CD) or ulcerative colitis (UC) were consecutively enrolled between October 2016 and February 2017. Active CD at enrollment was defined as a Harvey Bradshaw Index ≥ 8 or a CD Activity Index ≥ 220 or a calprotectin level > 200 μg/g or an active result based on colonoscopy suggestive of inadequate control during the previous year; active UC was defined as a partial Mayo score ≥ 5. Descriptive statistics were used to analyze all variables. RESULTS In a total of 407 included patients, CD was more frequent than UC, both overall (264 CD/143 UC patients) and by region (CD:UC ratios of 2.1 in the Southeast, 1.6 in the South and 1.2 in the Northeast/Midwest). The majority of patients were female (54.2% of CD; 56.6% of UC), and the mean ages were 45.9 ± 13.8 years (CD) and 42.9 ± 13.0 years (UC). The median disease duration was 10.0 (range: 0.5-45) years for both IBD types. At enrollment, 44.7% [95% confidence interval (CI): 38.7-50.7] of CD patients and 25.2% (95%CI: 18.1-32.3) of UC patients presented with active disease. More than 95% of IBD patients were receiving treatment at enrollment; CD patients were commonly treated with biologics (71.6%) and immunosuppressors (67.4%), and UC patients were commonly treated with mesalazine [5-Aminosalicylic acid (5-ASA)] derivates (69.9%) and immunosuppressors (44.1%). More than 50% of the CD patients had ileocolonic disease, and 41.7% presented with stricturing disease. One-quarter of CD patients had undergone CD-related surgery in the past 3 years, and this proportion was lower in the Northeast/Midwest region (2.9%). CONCLUSION In Brazil, there are regional variations in IBD management. CD outweighs UC in both frequency and disease activity. However, one-quarter of UC patients have active disease, and most are receiving 5-ASA treatment. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-06-25T10:51:56Z 2021-06-25T10:51:56Z 2021-01-14 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.3748/WJG.V27.I2.208 World Journal of Gastroenterology, v. 27, n. 2, p. 208-223, 2021. 2219-2840 1007-9327 http://hdl.handle.net/11449/207247 10.3748/WJG.V27.I2.208 2-s2.0-85100515563 |
url |
http://dx.doi.org/10.3748/WJG.V27.I2.208 http://hdl.handle.net/11449/207247 |
identifier_str_mv |
World Journal of Gastroenterology, v. 27, n. 2, p. 208-223, 2021. 2219-2840 1007-9327 10.3748/WJG.V27.I2.208 2-s2.0-85100515563 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
World Journal of Gastroenterology |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
208-223 |
dc.source.none.fl_str_mv |
Scopus reponame:Repositório Institucional da UNESP instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
institution |
UNESP |
reponame_str |
Repositório Institucional da UNESP |
collection |
Repositório Institucional da UNESP |
repository.name.fl_str_mv |
Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
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1808128206465662976 |