Aliment Pharmacol Ther. 2022 Jul 6. doi: 10.1111/apt.17125. Online ahead of print.
ABSTRACT
BACKGROUND: The global prevalence of inflammatory bowel disease (IBD) is increasing. However, population-level data are scarce for Asian populations.
AIMS: To outline and compare paediatric and adult IBD incidence and prevalence data in Korea, describe prescription patterns, and analyse outcomes of anti-tumour necrosis factor (anti-TNF) use in a nationally representative cohort.
METHODS: IBD was identified based on the presence of Rare and Intractable Disease diagnosis codes for Crohn’s disease (CD) and ulcerative colitis (UC). We calculated age-based prevalence and incidence, and examined prescription patterns. We used Cox proportional hazard model to calculate the hazard ratio (HR) for undergoing surgery.
RESULTS: The prevalence of CD increased between 2006 and 2015, particularly among teenagers aged 10-19 years (12.7-35.5 patients per 100,000 people). The use of anti-TNF agents increased from 3.2% to 22.9% in paediatric CD patients. Early use of an anti-TNF agent increased 25-fold in CD patients. Further, CD patients aged 0-14 years were most likely to undergo fistulectomy (HR, 2.63; 95% confidence interval [CI], 1.73-3.97). Children with UC had a higher risk of undergoing surgery (HR, 3.01; 95% CI, 1.33-6.83) than adults. Early use of an anti-TNF agent in CD patients was associated with lower odds of surgery than late-stage use.
CONCLUSION: These data demonstrate that the prevalence of IBD has increased over time, especially among paediatric patients. Given the magnitude of paediatric IBD disease burden, a multi-faceted approach is needed for early detection and vigilant monitoring to aim for better prognosis.
PMID:35791668 | DOI:10.1111/apt.17125
