The Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
University of North Carolina, Department of Pediatrics, Chapel Hill, NC, USA.
J Crohns Colitis. 2021 May 4;15(5):860-863. doi: 10.1093/ecco-jcc/jjaa243.
We aimed to describe physician practice patterns in holding or continuing IBD therapy in the setting of COVID-19 infection, using the Surveillance Epidemiology of Coronavirus Under Research Exclusion for Inflammatory Bowel Disease [SECURE-IBD] registry.
IBD medications that were stopped due to COVID-19 were recorded in the SECURE-IBD registry in addition to demographic and clinical data. We conducted descriptive analyses to understand characteristics associated with stopping IBD medications in response to active COVID-19 infection.
Of 1499 patients, IBD medications were stopped in 518 [34.6%] patients. On bivariate and multivariable analyses, a diagnosis of ulcerative colitis or IBD-unspecified was associated with a lower odds of stopping medication compared with Crohn's disease (adjusted odds ratio [aOR] 0.6, 95% confidence interval [CI] 0.48, 0.75). When evaluating specific medications, 5-aminosalicylic acid was more likely to be continued [p <0.001] whereas anti-tumour necrosis factor therapy and immunomodulator therapy were more likely to be stopped [global p <0.001]. Other demographic and clinical characteristics did not affect prescription patterns.
IBD medications other than immunomodulators were continued in the majority of IBD patients with COVID-19, in the international SECURE-IBD registry. Future studies are needed to understand the impact of stopping or continuing IBD medications on IBD- and COVID-19 related outcomes.
我们旨在利用 SECURE-IBD 登记处描述在 COVID-19 感染背景下,医生在进行 IBD 治疗时的实践模式。
除了人口统计学和临床数据外,SECURE-IBD 登记处还记录了因 COVID-19 而停止的 IBD 药物。我们进行了描述性分析,以了解与因活动性 COVID-19 感染而停止 IBD 药物相关的特征。
在 1499 名患者中,有 518 名(34.6%)患者停止了 IBD 药物治疗。在单变量和多变量分析中,与克罗恩病相比,溃疡性结肠炎或未特指的 IBD 诊断与停止药物治疗的可能性较低(调整后的优势比[aOR]0.6,95%置信区间[CI]0.48,0.75)。在评估特定药物时,5-氨基水杨酸更有可能继续使用(p<0.001),而抗 TNF 治疗和免疫调节剂治疗更有可能停止(总体 p<0.001)。其他人口统计学和临床特征并未影响处方模式。
在国际 SECURE-IBD 登记处,COVID-19 期间除免疫调节剂外,大多数 IBD 患者继续使用 IBD 药物。需要进一步研究以了解停止或继续 IBD 药物对 IBD 和 COVID-19 相关结果的影响。