Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark.
Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
Inflamm Bowel Dis. 2024 Nov 4;30(11):1965-1973. doi: 10.1093/ibd/izad244.
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.
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.
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.
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.
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。
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。
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。
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。
