Characteristics of Patients with Crohn’s Disease With or Without Perianal Fistulae in the CorEvitas Inflammatory Bowel Disease Registry
Background There are limited real-world data characterizing perianal fistulae in patients with Crohn’s disease (CD). Aim To describe characteristics of patients with CD with and without perianal fistulae. Methods In this cross-sectional study, characteristics, treatment history, and health outcomes...
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description | Background
There are limited real-world data characterizing perianal fistulae in patients with Crohn’s disease (CD).
Aim
To describe characteristics of patients with CD with and without perianal fistulae.
Methods
In this cross-sectional study, characteristics, treatment history, and health outcomes of patients with CD enrolled in the CorEvitas IBD Registry were described according to perianal fistula status (current/previous or none).
Results
Eight hundred and seventy-eight patients were included. Compared with patients with no perianal fistulae (
n
= 723), patients with current/previous perianal fistulae (
n
= 155) had longer disease duration since CD diagnosis (mean 16.5 vs 12.3 years; difference 4.3 years; 95% CI, 2.0, 6.6) and fewer had Harvey–Bradshaw Index scores indicative of remission (0–4, 56.8% vs 69.6%; difference − 12.9%; 95% CI, − 21.6, − 4.2). More patients with current/previous fistulae reported a history of IBD-related emergency room visits (67.7% vs 56.1%; difference 11.6%; 95% CI, 3.4, 19.8), hospitalizations (76.1% vs 58.4%; difference 17.7%; 95% CI, 10.1, 25.4), and surgeries (59.4% vs 27.7%; difference 31.7%; 95% CI, 23.3, 40.1), and a history of treatment with tumor necrosis factor inhibitors (81.3% vs 60.7%; difference 20.6%; 95% CI, 13.5, 27.7), immunosuppressants (51.6% vs 31.2%; difference 20.4%; 95% CI, 11.9, 29.0), and antibiotics (50.3% vs 23.7%; difference 26.6%; 95% CI, 18.2, 35.1) than patients without perianal fistulae.
Conclusions
Patients with CD with current/previous perianal fistulae have more symptomatic experiences of disease, higher medication use, hospitalization rates, and emergency room visits than patients without perianal fistulae. Interventions to prevent/reduce risk of developing fistulae may help improve outcomes in CD.
Graphical Abstract |
doi_str_mv | 10.1007/s10620-022-07491-y |
format | Article |
fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9883357</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A734961601</galeid><sourcerecordid>A734961601</sourcerecordid><originalsourceid>FETCH-LOGICAL-c541t-bb5e4adc8df015190bbbfc29a71f4ccc4f1b38b03ba19dde15797cadd1793cb63</originalsourceid><addsrcrecordid>eNp9UsFu1DAUtBCILgs_wAFZ4sIlxS-O7eSC1IYWKlWiQiCOluM4G1dJXGyn1d649hP6e3wJ3m7ZUoSQD896b2asNx6EXgLZB0LE2wCE5yQjeZ4RUVSQrR-hBTBBs5zx8jFaEODpDsD30LMQzgkhlQD-FO1RVnBBARbouu6VVzoab0O0OmDX4TMVrZliwFc29rj2rp9-_rgJ-L0NRgWDv23azt9WN0d8lshqUgM-ThrzoAy2E469wbXzR5c2qoBPpm5Q46ii82t86K7MsFP7bFaJ5tfP0ZNODcG8uKtL9PX46Ev9MTv99OGkPjjNNCsgZk3DTKFaXbYdAQYVaZqm03mlBHSF1rrooKFlQ2ijoGpbk_yohFZtC6KiuuF0id5tdS_mZjStTpt6NcgLb0fl19IpKx9OJtvLlbuUVVlSmtxdojd3At59n02IcrRBm2FQk3FzkDlnLP0PZyRBX_8FPXezT1YFSQkTjJZ5Lu5RKzUYaafOpXf1RlQeCFpUHDiBhNr_Byqd1oxWu8l0NvUfEPItQXsXgjfdbkcgchMguQ2QTAGStwGS60R69ac7O8rvxCQA3QJCGk0r4-9X-o_sLybF1Mg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3057538227</pqid></control><display><type>article</type><title>Characteristics of Patients with Crohn’s Disease With or Without Perianal Fistulae in the CorEvitas Inflammatory Bowel Disease Registry</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Fan, Yanni ; Delgado-Aros, Sílvia ; Valdecantos, Wendell C. ; Janak, Jud C. ; Moore, Page C. ; Crabtree, Margaux M. ; Stidham, Ryan W.</creator><creatorcontrib>Fan, Yanni ; Delgado-Aros, Sílvia ; Valdecantos, Wendell C. ; Janak, Jud C. ; Moore, Page C. ; Crabtree, Margaux M. ; Stidham, Ryan W.</creatorcontrib><description>Background
There are limited real-world data characterizing perianal fistulae in patients with Crohn’s disease (CD).
Aim
To describe characteristics of patients with CD with and without perianal fistulae.
Methods
In this cross-sectional study, characteristics, treatment history, and health outcomes of patients with CD enrolled in the CorEvitas IBD Registry were described according to perianal fistula status (current/previous or none).
Results
Eight hundred and seventy-eight patients were included. Compared with patients with no perianal fistulae (
n
= 723), patients with current/previous perianal fistulae (
n
= 155) had longer disease duration since CD diagnosis (mean 16.5 vs 12.3 years; difference 4.3 years; 95% CI, 2.0, 6.6) and fewer had Harvey–Bradshaw Index scores indicative of remission (0–4, 56.8% vs 69.6%; difference − 12.9%; 95% CI, − 21.6, − 4.2). More patients with current/previous fistulae reported a history of IBD-related emergency room visits (67.7% vs 56.1%; difference 11.6%; 95% CI, 3.4, 19.8), hospitalizations (76.1% vs 58.4%; difference 17.7%; 95% CI, 10.1, 25.4), and surgeries (59.4% vs 27.7%; difference 31.7%; 95% CI, 23.3, 40.1), and a history of treatment with tumor necrosis factor inhibitors (81.3% vs 60.7%; difference 20.6%; 95% CI, 13.5, 27.7), immunosuppressants (51.6% vs 31.2%; difference 20.4%; 95% CI, 11.9, 29.0), and antibiotics (50.3% vs 23.7%; difference 26.6%; 95% CI, 18.2, 35.1) than patients without perianal fistulae.
Conclusions
Patients with CD with current/previous perianal fistulae have more symptomatic experiences of disease, higher medication use, hospitalization rates, and emergency room visits than patients without perianal fistulae. Interventions to prevent/reduce risk of developing fistulae may help improve outcomes in CD.
Graphical Abstract</description><identifier>ISSN: 0163-2116</identifier><identifier>EISSN: 1573-2568</identifier><identifier>DOI: 10.1007/s10620-022-07491-y</identifier><identifier>PMID: 35467311</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Biochemistry ; Care and treatment ; Crohn Disease - complications ; Crohn Disease - diagnosis ; Crohn Disease - drug therapy ; Crohns disease ; Cross-Sectional Studies ; Emergency medical care ; Emergency medical services ; Gastroenterology ; Gastrointestinal diseases ; Health aspects ; Hepatology ; Humans ; Immunosuppressive agents ; Inflammatory bowel disease ; Medicine ; Medicine & Public Health ; Oncology ; Original ; Original Article ; Rectal Fistula - drug therapy ; Rectal Fistula - epidemiology ; Rectal Fistula - etiology ; Registries ; Transplant Surgery ; Treatment Outcome</subject><ispartof>Digestive diseases and sciences, 2023-01, Vol.68 (1), p.214-222</ispartof><rights>The Author(s) 2022</rights><rights>2022. The Author(s).</rights><rights>COPYRIGHT 2023 Springer</rights><rights>The Author(s) 2022. This work is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c541t-bb5e4adc8df015190bbbfc29a71f4ccc4f1b38b03ba19dde15797cadd1793cb63</citedby><cites>FETCH-LOGICAL-c541t-bb5e4adc8df015190bbbfc29a71f4ccc4f1b38b03ba19dde15797cadd1793cb63</cites><orcidid>0000-0001-9638-2186</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10620-022-07491-y$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10620-022-07491-y$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,315,781,785,886,27929,27930,41493,42562,51324</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35467311$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fan, Yanni</creatorcontrib><creatorcontrib>Delgado-Aros, Sílvia</creatorcontrib><creatorcontrib>Valdecantos, Wendell C.</creatorcontrib><creatorcontrib>Janak, Jud C.</creatorcontrib><creatorcontrib>Moore, Page C.</creatorcontrib><creatorcontrib>Crabtree, Margaux M.</creatorcontrib><creatorcontrib>Stidham, Ryan W.</creatorcontrib><title>Characteristics of Patients with Crohn’s Disease With or Without Perianal Fistulae in the CorEvitas Inflammatory Bowel Disease Registry</title><title>Digestive diseases and sciences</title><addtitle>Dig Dis Sci</addtitle><addtitle>Dig Dis Sci</addtitle><description>Background
There are limited real-world data characterizing perianal fistulae in patients with Crohn’s disease (CD).
Aim
To describe characteristics of patients with CD with and without perianal fistulae.
Methods
In this cross-sectional study, characteristics, treatment history, and health outcomes of patients with CD enrolled in the CorEvitas IBD Registry were described according to perianal fistula status (current/previous or none).
Results
Eight hundred and seventy-eight patients were included. Compared with patients with no perianal fistulae (
n
= 723), patients with current/previous perianal fistulae (
n
= 155) had longer disease duration since CD diagnosis (mean 16.5 vs 12.3 years; difference 4.3 years; 95% CI, 2.0, 6.6) and fewer had Harvey–Bradshaw Index scores indicative of remission (0–4, 56.8% vs 69.6%; difference − 12.9%; 95% CI, − 21.6, − 4.2). More patients with current/previous fistulae reported a history of IBD-related emergency room visits (67.7% vs 56.1%; difference 11.6%; 95% CI, 3.4, 19.8), hospitalizations (76.1% vs 58.4%; difference 17.7%; 95% CI, 10.1, 25.4), and surgeries (59.4% vs 27.7%; difference 31.7%; 95% CI, 23.3, 40.1), and a history of treatment with tumor necrosis factor inhibitors (81.3% vs 60.7%; difference 20.6%; 95% CI, 13.5, 27.7), immunosuppressants (51.6% vs 31.2%; difference 20.4%; 95% CI, 11.9, 29.0), and antibiotics (50.3% vs 23.7%; difference 26.6%; 95% CI, 18.2, 35.1) than patients without perianal fistulae.
Conclusions
Patients with CD with current/previous perianal fistulae have more symptomatic experiences of disease, higher medication use, hospitalization rates, and emergency room visits than patients without perianal fistulae. Interventions to prevent/reduce risk of developing fistulae may help improve outcomes in CD.
Graphical Abstract</description><subject>Biochemistry</subject><subject>Care and treatment</subject><subject>Crohn Disease - complications</subject><subject>Crohn Disease - diagnosis</subject><subject>Crohn Disease - drug therapy</subject><subject>Crohns disease</subject><subject>Cross-Sectional Studies</subject><subject>Emergency medical care</subject><subject>Emergency medical services</subject><subject>Gastroenterology</subject><subject>Gastrointestinal diseases</subject><subject>Health aspects</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Immunosuppressive agents</subject><subject>Inflammatory bowel disease</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Oncology</subject><subject>Original</subject><subject>Original Article</subject><subject>Rectal Fistula - drug therapy</subject><subject>Rectal Fistula - epidemiology</subject><subject>Rectal Fistula - etiology</subject><subject>Registries</subject><subject>Transplant Surgery</subject><subject>Treatment Outcome</subject><issn>0163-2116</issn><issn>1573-2568</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9UsFu1DAUtBCILgs_wAFZ4sIlxS-O7eSC1IYWKlWiQiCOluM4G1dJXGyn1d649hP6e3wJ3m7ZUoSQD896b2asNx6EXgLZB0LE2wCE5yQjeZ4RUVSQrR-hBTBBs5zx8jFaEODpDsD30LMQzgkhlQD-FO1RVnBBARbouu6VVzoab0O0OmDX4TMVrZliwFc29rj2rp9-_rgJ-L0NRgWDv23azt9WN0d8lshqUgM-ThrzoAy2E469wbXzR5c2qoBPpm5Q46ii82t86K7MsFP7bFaJ5tfP0ZNODcG8uKtL9PX46Ev9MTv99OGkPjjNNCsgZk3DTKFaXbYdAQYVaZqm03mlBHSF1rrooKFlQ2ijoGpbk_yohFZtC6KiuuF0id5tdS_mZjStTpt6NcgLb0fl19IpKx9OJtvLlbuUVVlSmtxdojd3At59n02IcrRBm2FQk3FzkDlnLP0PZyRBX_8FPXezT1YFSQkTjJZ5Lu5RKzUYaafOpXf1RlQeCFpUHDiBhNr_Byqd1oxWu8l0NvUfEPItQXsXgjfdbkcgchMguQ2QTAGStwGS60R69ac7O8rvxCQA3QJCGk0r4-9X-o_sLybF1Mg</recordid><startdate>20230101</startdate><enddate>20230101</enddate><creator>Fan, Yanni</creator><creator>Delgado-Aros, Sílvia</creator><creator>Valdecantos, Wendell C.</creator><creator>Janak, Jud C.</creator><creator>Moore, Page C.</creator><creator>Crabtree, Margaux M.</creator><creator>Stidham, Ryan W.</creator><general>Springer US</general><general>Springer</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-9638-2186</orcidid></search><sort><creationdate>20230101</creationdate><title>Characteristics of Patients with Crohn’s Disease With or Without Perianal Fistulae in the CorEvitas Inflammatory Bowel Disease Registry</title><author>Fan, Yanni ; Delgado-Aros, Sílvia ; Valdecantos, Wendell C. ; Janak, Jud C. ; Moore, Page C. ; Crabtree, Margaux M. ; Stidham, Ryan W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c541t-bb5e4adc8df015190bbbfc29a71f4ccc4f1b38b03ba19dde15797cadd1793cb63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Biochemistry</topic><topic>Care and treatment</topic><topic>Crohn Disease - complications</topic><topic>Crohn Disease - diagnosis</topic><topic>Crohn Disease - drug therapy</topic><topic>Crohns disease</topic><topic>Cross-Sectional Studies</topic><topic>Emergency medical care</topic><topic>Emergency medical services</topic><topic>Gastroenterology</topic><topic>Gastrointestinal diseases</topic><topic>Health aspects</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Immunosuppressive agents</topic><topic>Inflammatory bowel disease</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Oncology</topic><topic>Original</topic><topic>Original Article</topic><topic>Rectal Fistula - drug therapy</topic><topic>Rectal Fistula - epidemiology</topic><topic>Rectal Fistula - etiology</topic><topic>Registries</topic><topic>Transplant Surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fan, Yanni</creatorcontrib><creatorcontrib>Delgado-Aros, Sílvia</creatorcontrib><creatorcontrib>Valdecantos, Wendell C.</creatorcontrib><creatorcontrib>Janak, Jud C.</creatorcontrib><creatorcontrib>Moore, Page C.</creatorcontrib><creatorcontrib>Crabtree, Margaux M.</creatorcontrib><creatorcontrib>Stidham, Ryan W.</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Proquest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Digestive diseases and sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fan, Yanni</au><au>Delgado-Aros, Sílvia</au><au>Valdecantos, Wendell C.</au><au>Janak, Jud C.</au><au>Moore, Page C.</au><au>Crabtree, Margaux M.</au><au>Stidham, Ryan W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Characteristics of Patients with Crohn’s Disease With or Without Perianal Fistulae in the CorEvitas Inflammatory Bowel Disease Registry</atitle><jtitle>Digestive diseases and sciences</jtitle><stitle>Dig Dis Sci</stitle><addtitle>Dig Dis Sci</addtitle><date>2023-01-01</date><risdate>2023</risdate><volume>68</volume><issue>1</issue><spage>214</spage><epage>222</epage><pages>214-222</pages><issn>0163-2116</issn><eissn>1573-2568</eissn><abstract>Background
There are limited real-world data characterizing perianal fistulae in patients with Crohn’s disease (CD).
Aim
To describe characteristics of patients with CD with and without perianal fistulae.
Methods
In this cross-sectional study, characteristics, treatment history, and health outcomes of patients with CD enrolled in the CorEvitas IBD Registry were described according to perianal fistula status (current/previous or none).
Results
Eight hundred and seventy-eight patients were included. Compared with patients with no perianal fistulae (
n
= 723), patients with current/previous perianal fistulae (
n
= 155) had longer disease duration since CD diagnosis (mean 16.5 vs 12.3 years; difference 4.3 years; 95% CI, 2.0, 6.6) and fewer had Harvey–Bradshaw Index scores indicative of remission (0–4, 56.8% vs 69.6%; difference − 12.9%; 95% CI, − 21.6, − 4.2). More patients with current/previous fistulae reported a history of IBD-related emergency room visits (67.7% vs 56.1%; difference 11.6%; 95% CI, 3.4, 19.8), hospitalizations (76.1% vs 58.4%; difference 17.7%; 95% CI, 10.1, 25.4), and surgeries (59.4% vs 27.7%; difference 31.7%; 95% CI, 23.3, 40.1), and a history of treatment with tumor necrosis factor inhibitors (81.3% vs 60.7%; difference 20.6%; 95% CI, 13.5, 27.7), immunosuppressants (51.6% vs 31.2%; difference 20.4%; 95% CI, 11.9, 29.0), and antibiotics (50.3% vs 23.7%; difference 26.6%; 95% CI, 18.2, 35.1) than patients without perianal fistulae.
Conclusions
Patients with CD with current/previous perianal fistulae have more symptomatic experiences of disease, higher medication use, hospitalization rates, and emergency room visits than patients without perianal fistulae. Interventions to prevent/reduce risk of developing fistulae may help improve outcomes in CD.
Graphical Abstract</abstract><cop>New York</cop><pub>Springer US</pub><pmid>35467311</pmid><doi>10.1007/s10620-022-07491-y</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-9638-2186</orcidid><oa>free_for_read</oa></addata></record> |
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source | MEDLINE; SpringerNature Journals |
subjects | Biochemistry Care and treatment Crohn Disease - complications Crohn Disease - diagnosis Crohn Disease - drug therapy Crohns disease Cross-Sectional Studies Emergency medical care Emergency medical services Gastroenterology Gastrointestinal diseases Health aspects Hepatology Humans Immunosuppressive agents Inflammatory bowel disease Medicine Medicine & Public Health Oncology Original Original Article Rectal Fistula - drug therapy Rectal Fistula - epidemiology Rectal Fistula - etiology Registries Transplant Surgery Treatment Outcome |
title | Characteristics of Patients with Crohn’s Disease With or Without Perianal Fistulae in the CorEvitas Inflammatory Bowel Disease Registry |
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