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日本炎症性肠病患者静脉血栓栓塞症的真实世界保险索赔分析。

Real-World Insurance Claims Analysis of Venous Thromboembolism in Japanese Patients with Inflammatory Bowel Disease.

机构信息

Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, 2-1 Midorigaoka-Higashi, Asahikawa, 078-8510, Japan.

Immunology & Inflammation Medical Affairs, Pfizer Japan Inc, Shinjuku Culture Quint Bldg 3-22-7 Yoyogi Shibuya-ku, Tokyo, 151-8589, Japan.

出版信息

Dig Dis Sci. 2022 Nov;67(11):5195-5205. doi: 10.1007/s10620-022-07388-w. Epub 2022 Feb 12.

Abstract

BACKGROUND

Inflammatory bowel disease (IBD), which encompasses both ulcerative colitis (UC) and Crohn's disease (CD), is a risk factor for venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE).

AIM

To investigate the incidence of, and risk factors for, VTE in patients with IBD in Japan.

METHODS

This was a retrospective, non-interventional study in patients with IBD from the Japan Medical Data Center claims database. Incidence rates (IRs; unique patients with events per 100 patient-years) were calculated for VTE, DVT, and PE among the IBD, UC, and CD cohorts. Odds ratios of potential risk factors were calculated by univariate and multivariate analyses in a nested case-control design.

RESULTS

Overall, 16 273 patients with IBD were included: 13 585 with UC and 3443 with CD. VTE events occurred in 1.3%, 1.2%, and 1.9% of patients with IBD, UC, and CD, respectively. In patients with IBD, UC, and CD, IRs of VTE were 0.45, 0.40, and 0.64, respectively, IRs of DVT were 0.42, 0.38, and 0.61, respectively, and IRs of PE were 0.07, 0.07, and 0.11, respectively. In patients with IBD, treatment history (immunomodulators), cardiovascular risk (hypertension, high-density lipoprotein or diabetes mellitus, and history of coronary artery disease or heart failure), malignancy, and undergoing major surgery were identified as potential risk factors for VTE in the multivariate analysis, with similar risk factors reported for patients with UC and CD.

CONCLUSIONS

This large study provides insight into the incidence and risk factors for VTE in patients with IBD from Japan.

摘要

背景

炎症性肠病(IBD)包括溃疡性结肠炎(UC)和克罗恩病(CD),是静脉血栓栓塞症(VTE)的一个风险因素,VTE 包括深静脉血栓形成(DVT)和肺栓塞(PE)。

目的

研究日本 IBD 患者 VTE 的发生率和风险因素。

方法

这是一项来自日本医疗数据中心索赔数据库的回顾性、非干预性 IBD 患者研究。在 IBD、UC 和 CD 队列中,计算 VTE、DVT 和 PE 的发生率(IR;每 100 名患者年中发生事件的独特患者数)。在巢式病例对照设计中,通过单变量和多变量分析计算潜在风险因素的比值比。

结果

共有 16273 例 IBD 患者被纳入研究:13585 例 UC 和 3443 例 CD。IBD、UC 和 CD 患者中 VTE 事件的发生率分别为 1.3%、1.2%和 1.9%。在 IBD 患者中,VTE、DVT 和 PE 的 IR 分别为 0.45、0.42 和 0.07;UC 患者分别为 0.40、0.38 和 0.07;CD 患者分别为 0.64、0.61 和 0.11。在 IBD 患者中,治疗史(免疫调节剂)、心血管风险(高血压、高密度脂蛋白或糖尿病以及冠心病或心力衰竭史)、恶性肿瘤和大手术被确定为 VTE 的潜在风险因素,在 UC 和 CD 患者中也有类似的风险因素报告。

结论

这项大型研究提供了日本 IBD 患者 VTE 的发生率和风险因素的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fff/9587926/8af33f93fef7/10620_2022_7388_Fig1_HTML.jpg

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