Effectiveness and Safety of Biologic Therapy in Hispanic Vs Non-Hispanic Patients With Inflammatory Bowel Diseases: A CA-IBD Cohort Study.

Adult Female Humans Male Biological Products / adverse effects Biological Therapy Cohort Studies Colitis, Ulcerative / drug therapy Retrospective Studies Tumor Necrosis Factor Inhibitors / therapeutic use Tumor Necrosis Factor-alpha / antagonists & inhibitors
Crohn’s Disease Disparities Ethnic Minorities Immunosuppressives Social Determinants of Health

Journal

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
ISSN: 1542-7714
Titre abrégé: Clin Gastroenterol Hepatol
Pays: United States
ID NLM: 101160775

Informations de publication

Date de publication:
01 2023
Historique:
received: 05 02 2022
revised: 09 04 2022
accepted: 05 05 2022
pmc-release: 01 01 2024
pubmed: 2 6 2022
medline: 27 12 2022
entrez: 1 6 2022
Statut: ppublish

Résumé

There are limited data on outcomes of biologic therapy in Hispanic patients with inflammatory bowel diseases (IBDs). We compared risk of hospitalization, surgery, and serious infections in Hispanic vs non-Hispanic patients with IBD in a multicenter, electronic health record-based cohort of biologic-treated patients. We identified adult patients with IBD who were new users of biologic agents (tumor necrosis factor α [TNF-α] antagonists, ustekinumab, vedolizumab) from 5 academic institutions in California between 2010 and 2017. We compared the risk of all-cause hospitalization, IBD-related surgery, and serious infections in Hispanic vs non-Hispanic patients using 1:4 propensity score matching and survival analysis. We compared 240 Hispanic patients (53% male; 45% with ulcerative colitis; 73% TNF-α antagonist-treated; 20% with prior biologic exposure) with 960 non-Hispanic patients (51% male; 44% with ulcerative colitis; 67% TNF-α antagonist-treated; 27% with prior biologic exposure). After propensity score matching, Hispanic patients were younger (37 ± 15 vs 40 ± 16 y; P = .02) and had a higher burden of comorbidities (Elixhauser index, >0; 37% vs 26%; P < .01), without any differences in patterns of medication use, burden of inflammation, and hospitalizations. Within 1 year of biologic initiation, Hispanic patients had higher rates of hospitalizations (31% vs 23%; adjusted hazard ratio [aHR], 1.32; 95% CI, 1.01-1.74) and IBD-related surgery (7.1% vs 4.6%; aHR, 2.00; 95% CI, 1.07-3.72), with a trend toward higher risk of serious infections (8.8% vs 4.9%; aHR, 1.74; 95% CI, 0.99-3.05). In a multicenter, propensity score-matched cohort of biologic-treated patients with IBD, Hispanic patients experienced higher rates of hospitalization, surgery, and serious infections. Future studies are needed to investigate the biological, social, and environmental drivers of these differences.

Sections du résumé

BACKGROUND & AIMS
There are limited data on outcomes of biologic therapy in Hispanic patients with inflammatory bowel diseases (IBDs). We compared risk of hospitalization, surgery, and serious infections in Hispanic vs non-Hispanic patients with IBD in a multicenter, electronic health record-based cohort of biologic-treated patients.
METHODS
We identified adult patients with IBD who were new users of biologic agents (tumor necrosis factor α [TNF-α] antagonists, ustekinumab, vedolizumab) from 5 academic institutions in California between 2010 and 2017. We compared the risk of all-cause hospitalization, IBD-related surgery, and serious infections in Hispanic vs non-Hispanic patients using 1:4 propensity score matching and survival analysis.
RESULTS
We compared 240 Hispanic patients (53% male; 45% with ulcerative colitis; 73% TNF-α antagonist-treated; 20% with prior biologic exposure) with 960 non-Hispanic patients (51% male; 44% with ulcerative colitis; 67% TNF-α antagonist-treated; 27% with prior biologic exposure). After propensity score matching, Hispanic patients were younger (37 ± 15 vs 40 ± 16 y; P = .02) and had a higher burden of comorbidities (Elixhauser index, >0; 37% vs 26%; P < .01), without any differences in patterns of medication use, burden of inflammation, and hospitalizations. Within 1 year of biologic initiation, Hispanic patients had higher rates of hospitalizations (31% vs 23%; adjusted hazard ratio [aHR], 1.32; 95% CI, 1.01-1.74) and IBD-related surgery (7.1% vs 4.6%; aHR, 2.00; 95% CI, 1.07-3.72), with a trend toward higher risk of serious infections (8.8% vs 4.9%; aHR, 1.74; 95% CI, 0.99-3.05).
CONCLUSIONS
In a multicenter, propensity score-matched cohort of biologic-treated patients with IBD, Hispanic patients experienced higher rates of hospitalization, surgery, and serious infections. Future studies are needed to investigate the biological, social, and environmental drivers of these differences.

Identifiants

DOI: 10.1016/j.cgh.2022.05.008 PMID: 35644340 PMC: PMC9701245
pubmed: 35644340
pii: S1542-3565(22)00518-3
doi: 10.1016/j.cgh.2022.05.008
pmc: PMC9701245
mid: NIHMS1811328
pii:
doi:

Substances chimiques

Biological Products 0
Tumor Necrosis Factor Inhibitors 0
Tumor Necrosis Factor-alpha 0

Types de publication

Comparative Study Journal Article Multicenter Study Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

173-181.e5

Subventions

Organisme : NHLBI NIH HHS
ID : R01 HL136835
Pays : United States
Organisme : NHGRI NIH HHS
ID : R01 HG011066
Pays : United States
Organisme : NLM NIH HHS
ID : U24 LM013755
Pays : United States
Organisme : NIDDK NIH HHS
ID : T32 DK007202
Pays : United States
Organisme : NIH HHS
ID : OT2 OD024611
Pays : United States
Organisme : NIDDK NIH HHS
ID : R03 DK129631
Pays : United States
Organisme : NIGMS NIH HHS
ID : R01 GM118609
Pays : United States
Organisme : NIDDK NIH HHS
ID : K23 DK117058
Pays : United States
Organisme : NIH HHS
ID : OT2 OD026552
Pays : United States
Organisme : NIDDK NIH HHS
ID : P30 DK120515
Pays : United States
Organisme : AHRQ HHS
ID : R01 HS019913
Pays : United States
Organisme : NLM NIH HHS
ID : T15 LM011271
Pays : United States

Informations de copyright

Copyright © 2023 AGA Institute. Published by Elsevier Inc. All rights reserved.

Auteurs

Nghia H Nguyen (NH)

Division of Gastroenterology, Department of Medicine, UC San Diego, La Jolla, California; Division of Biomedical Informatics, Department of Medicine, UC San Diego, La Jolla, California.

Jiyu Luo (J)

Division of Biostatistics and Bioinformatics, Department of Family Medicine and Public Health, UC San Diego, La Jolla, California.

Paulina Paul (P)

Division of Biomedical Informatics, Department of Medicine, UC San Diego, La Jolla, California.

Jihoon Kim (J)

Division of Biomedical Informatics, Department of Medicine, UC San Diego, La Jolla, California.

Gaurav Syal (G)

Karsh Division of Gastroenterology and Hepatology, Department of Medicine, Cedars-Sinai Medical System, Los Angeles, California.

Christina Ha (C)

Division of Gastroenterology, Mayo Clinic, Scottsdale, Arizona.

Vivek Rudrapatna (V)

Division of Gastroenterology, Department of Medicine, UC San Francisco, California.

Sunhee Park (S)

Division of Gastroenterology, Department of Medicine, UC Irvine, Orange, California.

Nimisha Parekh (N)

Division of Gastroenterology, Department of Medicine, UC Irvine, Orange, California.

Kai Zheng (K)

Department of Informatics, Donald Bren School of Information and Computer Sciences, UC Irvine, Orange, California.

Jenny S Sauk (JS)

Vatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, UC Los Angeles, Los Angeles, California.

Berkeley Limketkai (B)

Vatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, UC Los Angeles, Los Angeles, California.

Phillip Fleshner (P)

Division of Colorectal Surgery, Department of Surgery, Cedars-Sinai Medical System, Los Angeles, California.

Samuel Eisenstein (S)

Division of Colon and Rectal Surgery, Department of Surgery, UC San Diego, La Jolla, California.

Sonia Ramamoorthy (S)

Division of Colon and Rectal Surgery, Department of Surgery, UC San Diego, La Jolla, California.

Gil Melmed (G)

Karsh Division of Gastroenterology and Hepatology, Department of Medicine, Cedars-Sinai Medical System, Los Angeles, California.

Parambir S Dulai (PS)

Division of Gastroenterology, Department of Medicine, Northwestern University, Chicago, Illinois.

Brigid S Boland (BS)

Division of Gastroenterology, Department of Medicine, UC San Diego, La Jolla, California.

Uma Mahadevan (U)

Division of Gastroenterology, Department of Medicine, UC San Francisco, California.

William J Sandborn (WJ)

Division of Gastroenterology, Department of Medicine, UC San Diego, La Jolla, California.

Lucila Ohno-Machado (L)

Division of Biomedical Informatics, Department of Medicine, UC San Diego, La Jolla, California.

Dermot McGovern (D)

Karsh Division of Gastroenterology and Hepatology, Department of Medicine, Cedars-Sinai Medical System, Los Angeles, California.

Siddharth Singh (S)

Division of Gastroenterology, Department of Medicine, UC San Diego, La Jolla, California; Division of Biomedical Informatics, Department of Medicine, UC San Diego, La Jolla, California. Electronic address: sis040@ucsd.edu.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Effectiveness and Safety of Biologic Therapy...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Effectiveness and Safety of Biologic Therapy...
questionsmedicales.fr › Mélanges complexes › Produits biologiques › Effectiveness and Safety of Biologic Therapy...
questionsmedicales.fr › Thérapeutique › Biothérapie › Effectiveness and Safety of Biologic Therapy...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Effectiveness and Safety of Biologic Therapy...
questionsmedicales.fr › Maladies de l'appareil digestif › Maladies gastro-intestinales › Maladies intestinales › Maladies inflammatoires intestinales › Rectocolite hémorragique › Effectiveness and Safety of Biologic Therapy...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Effectiveness and Safety of Biologic Therapy...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Anti-inflammatoires › Inhibiteurs du facteur de nécrose tumorale › Effectiveness and Safety of Biologic Therapy...
questionsmedicales.fr › Facteurs biologiques › Protéines et peptides de signalisation intercellulaire › Cytokines › Facteurs de nécrose tumorale › Facteur de nécrose tumorale alpha › Effectiveness and Safety of Biologic Therapy...