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成人和老年人炎症性肠病:在全国队列研究中检查选定的非 IBD 药物的使用。

Inflammatory Bowel Disease in Adults and Elderly: The Use of Selected Non-IBD Medication Examined in a Nationwide Cohort Study.

机构信息

Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark.

Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.

出版信息

Inflamm Bowel Dis. 2024 Nov 4;30(11):1965-1973. doi: 10.1093/ibd/izad244.

Abstract

BACKGROUND

Real-world data on medications used for conditions other than inflammatory bowel disease (IBD) are sparse. We examined how the onset of IBD affects the prescription pattern of selected non-IBD medication and the risk of becoming an incident user.

METHODS

This nationwide cohort study utilized data from Danish health registers. We included incident patients with young adult-onset IBD (18-39 years of age), adult-onset IBD (40-59 years of age), and elderly-onset IBD (60+ years of age), from 1998 to 2018 and followed all for 3 years. We examined redeemed prescriptions before and after the onset of IBD and estimated the risk of becoming a user of non-IBD medications using logistic regression models.

RESULTS

We identified 36165 patients, 16 771 (46%) with young adult onset, 10615 (29%) with adult onset, and 8779 (24%) with elderly onset. The onset of IBD increased the use of antidepressants, antipsychotics, sedatives/hypnotics, opioids, nonopioid analgesics, antidiabetics, and proton pump inhibitors, even in patients with no other underlying comorbid diseases. The adjusted odds ratio for using antidepressants 1 year after the onset of IBD in elderly was 1.50 (95% confidence interval [CI], 1.14-1.82), in opioids 1.69 (95% CI, 1.45-1.95), in nonopioid analgesics 2.10 (95% CI, 1.77-2.48), in cardiovascular medication 2.20 (95% CI, 1.86-2.61), and in proton pump inhibitors 1.51 (95% CI, 1.31-1.74) compared with adults.

CONCLUSIONS

In all 3 age groups, the proportions of patients with redeemed prescriptions for several groups of non-IBD medication were significantly increased after the IBD diagnosis compared with before. The risk of becoming an incident user for several groups of non-IBD medication was increased in elderly patients.

摘要

背景

关于用于非炎症性肠病(IBD)疾病的药物的真实世界数据很少。我们研究了 IBD 的发病如何影响选定的非 IBD 药物的处方模式以及成为发病使用者的风险。

方法

本全国性队列研究利用了丹麦健康登记处的数据。我们纳入了在 1998 年至 2018 年期间发病的青年发病(18-39 岁)、成年发病(40-59 岁)和老年发病(60 岁以上)的 IBD 患者,并对他们进行了 3 年的随访。我们检查了 IBD 发病前后的处方情况,并使用逻辑回归模型估计了成为非 IBD 药物使用者的风险。

结果

我们确定了 36165 名患者,其中 16771 名(46%)为青年发病,10615 名(29%)为成年发病,8779 名(24%)为老年发病。IBD 的发病增加了抗抑郁药、抗精神病药、镇静剂/催眠药、阿片类药物、非阿片类镇痛药、抗糖尿病药和质子泵抑制剂的使用,即使在没有其他潜在合并症的患者中也是如此。发病后 1 年,老年患者使用抗抑郁药的调整比值比为 1.50(95%置信区间[CI],1.14-1.82),使用阿片类药物的比值比为 1.69(95%CI,1.45-1.95),使用非阿片类镇痛药的比值比为 2.10(95%CI,1.77-2.48),使用心血管药物的比值比为 2.20(95%CI,1.86-2.61),使用质子泵抑制剂的比值比为 1.51(95%CI,1.31-1.74),与成年患者相比。

结论

在所有 3 个年龄组中,与发病前相比,IBD 诊断后,几个非 IBD 药物组的患者处方比例均显著增加。老年患者成为几种非 IBD 药物发病使用者的风险增加。

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