Decreasing trends in hospitalizations during anti-TNF therapy are associated with time to anti-TNF therapy: Results from two referral centres

Michael D. Mandel, Anita Balint, Petra A. Golovics, Zsuzsanna Vegh, Anna Mohas, Blanka Szilagyi, Agnes Szabo, Zsuzsanna Kurti, Lajos S. Kiss, Barbara D. Lovasz, Krisztina B. Gecse, Klaudia Farkas, Tamas Molnar, Peter L. Lakatos

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13 Citations (Scopus)

Abstract

Background: Hospitalization is an important outcome measure and a major driver of costs in patients with inflammatory bowel disease. We analysed medical and surgical hospitalization rates and predictors of hospitalization before and during anti-TNF therapy. Methods: Data from 194 consecutive patients were analysed retrospectively (males, 45.4%, median age at diagnosis, 24.0 years, infliximab/adalimumab: 144/50) in whom anti-TNF therapy was started after January 1, 2008. Total follow-up was 1874 patient-years and 474 patient-years with anti-TNF exposure. Results: Hospitalization rates hospitalization decreased only in Crohn's disease (odds ratio: 0.59, 95% confidence interval: 0.51-0.70, median 2-years' anti-TNF exposure) with a same trend for surgical interventions (. p=. 0.07), but not in ulcerative colitis. Need for hospitalization decreased in Crohn's disease with early (within 3-years from diagnosis, p=. 0.016 by McNemar test), but not late anti-TNF exposure. At logistic regression analysis complicated disease behaviour (. p=. 0.03), concomitant azathioprine (. p=. 0.02) use, but not anti-TNF type, gender, perianal disease or previous surgeries were associated with the risk of hospitalization during anti-TNF therapy. Conclusion: Hospitalization rate decreased significantly in patients with Crohn's disease but not ulcerative colitis after the introduction of anti-TNF therapy and was associated with time to therapy. Complicated disease phenotype and concomitant azathioprine use were additional factors defining the risk of hospitalization.

Original languageEnglish
Pages (from-to)985-990
Number of pages6
JournalDigestive and Liver Disease
Volume46
Issue number11
DOIs
Publication statusPublished - Nov 1 2014

Keywords

  • Adalimumab
  • Anti-TNF infliximab
  • CD
  • Hospitalization
  • Risk
  • Surgery
  • UC

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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    Mandel, M. D., Balint, A., Golovics, P. A., Vegh, Z., Mohas, A., Szilagyi, B., Szabo, A., Kurti, Z., Kiss, L. S., Lovasz, B. D., Gecse, K. B., Farkas, K., Molnar, T., & Lakatos, P. L. (2014). Decreasing trends in hospitalizations during anti-TNF therapy are associated with time to anti-TNF therapy: Results from two referral centres. Digestive and Liver Disease, 46(11), 985-990. https://doi.org/10.1016/j.dld.2014.07.168