Morikubo Hiromu, Nagahama Takayoshi, Nagai Katsuhiko, Yamazaki Hajime, Kobayashi Taku
Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, Japan.
JMDC Inc., Tokyo, Japan.
Inflamm Intest Dis. 2024 Oct 14;9(1):260-270. doi: 10.1159/000541984. eCollection 2024 Jan-Dec.
There is a close relationship between the relapse of inflammatory bowel disease (IBD) and lifestyle factors, including concomitant medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), antithrombotic drugs, smoking status, and alcohol consumption. However, solid evidence is limited regarding the risk factors at diagnosis and initial disease course. This study aimed to explore the impact of concomitant prescriptions and lifestyle factors in patients with newly diagnosed IBD using a large-scale real-world database.
This is a retrospective inception cohort study using the insurance claims database. Newly diagnosed patients with UC and CD were enrolled between January 2005 and May 2020. Concomitant prescriptions and lifestyle factors were assessed for new biologics use, surgery, and hospitalization during the first year.
In total, 6,743 patients with UC and 1,000 patients with CD were enrolled. Proton pump inhibitors, antithrombotics, antibiotics, and NSAIDs were identified as associated factors for both biologics use and hospitalization in UC patients (all < 0.01), and antithrombotics were identified as associated factors for both biologics use and hospitalization in CD patients (all < 0.01) in multivariable analyses. Interestingly, smoking was protective against hospitalization in UC patients ( < 0.01) but not in CD patients ( = 0.997), analyzed by univariate analysis. Alcohol consumption was protective against hospitalization outcomes in UC patients ( = 0.02) but not in CD patients ( = 0.27), analyzed by univariate analysis.
Immediate attention should be paid to concomitant medications at diagnosis because they may have impact on the initial course of IBD.
炎症性肠病（IBD）的复发与生活方式因素密切相关，包括同时使用的药物，如非甾体抗炎药（NSAIDs）、抗血栓药物、吸烟状况和饮酒情况。然而，关于诊断时和疾病初始阶段的危险因素，确凿证据有限。本研究旨在利用大规模真实世界数据库探讨新诊断的IBD患者同时使用的处方药物和生活方式因素的影响。
这是一项使用保险理赔数据库的回顾性起始队列研究。2005年1月至2020年5月期间纳入新诊断的溃疡性结肠炎（UC）和克罗恩病（CD）患者。评估了第一年期间新生物制剂使用、手术和住院情况的同时使用的处方药物和生活方式因素。
共纳入6743例UC患者和1000例CD患者。在多变量分析中，质子泵抑制剂、抗血栓药物、抗生素和NSAIDs被确定为UC患者生物制剂使用和住院的相关因素（均<0.01），抗血栓药物被确定为CD患者生物制剂使用和住院的相关因素（均<0.01）。有趣的是，单因素分析显示，吸烟对UC患者住院有保护作用（<0.01），但对CD患者无保护作用（=0.997）。单因素分析显示，饮酒对UC患者住院结局有保护作用（=0.02），但对CD患者无保护作用（=0.27）。
诊断时应立即关注同时使用的药物，因为它们可能对IBD的初始病程产生影响。
