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Su1303 Prevalence and Disease Characteristics of Inflammatory Bowel Disease (IBD) in Chinese: Results From a Nationwide Population-Based Registry
Table 1: Disease Demographics in Europeans and non-Europeans with IBD
Su1304
Background and Aims: We previously reported that approximately 40-50% of persons with IBD may not be using IBD-specific medications at any given time. In the current analysis, we evaluated potential factors associated with a delay in the initiation of any IBD-specific medication following diagnosis and factors associated with becoming a long-term nonuser (defined as no IBD-specific medications use for a year or longer) following the initiation of IBD-specific medications among a population based cohort of persons with IBD. Methods: All incident cases of IBD diagnosed between 1996 and 2012 were identified from the population-based University of Manitoba IBD Epidemiology Database. Study subjects were followed from diagnosis date until death, outmigration or end of database follow-up (March 31st, 2012). Comprehensive prescription drug data became available after 1995 and all dispensations since 1996 were used in the analysis. Cox proportional hazard models were used to identify factors associated with delayed initiation and with becoming a long-term nonuser of IBD-specific medication. Results: A total of 3902 subjects with IBD (47% male, 47% with Crohn's disease (CD)) were followed for an average duration of years after IBD diagnosis. Among those followed at least for 1 year, 5 years and 10 years after IBD diagnosis, approximately 11.7%, 6.2% and 4.1% were never dispensed any IBD-specific medication respectively. Persons with CD (HR=0.78; 95%CI: 0.73-0.83), of lower socio-economic status (SES ) (HR=0.91; 95%CI: 0.84-0.98), urbanites (HR=0.87, 95%CI: 0.82-0.93), age over 65 (HR=0.76; 95%CI: 0.67-0.86), and having any comorbidity were more likely to delay initiating first IBD-specific medication following diagnosis. Among subjects who were dispensed at least one IBD-specific medication following diagnosis (n=3708), persons with CD (HR=1.14; 95%CI: 1.04-1.25), of lower SES (HR=1.14, 95%CI: 1.02-1.27), being diagnosed in late 1990s or early 2000s, having had surgery (HR=1.72, 95%CI: 1.51-1.96), or delayed initiation of first IBD medication following diagnosis were more likely to become long-term nonusers after initiation. Conclusions and Relevance: Having CD, being of lower SES, being an urbanite, or having comorbidities were more likely to delay initiating IBD-specific medication. Persons with CD, of lower SES, having surgery, or having delayed initiation of first IBD-specific medication are associated with a greater likelihood of becoming a nonuser once IBD-specific medications were initiated. The longer patients wait to initiate IBD-specific medication following diagnosis, the poorer the adherence and quickly become long-term nonusers. Further work is required to evaluate the clinical implications of delayed initiation and long-term medication nonuse in IBD.
Su1303 Prevalence and Disease Characteristics of Inflammatory Bowel Disease (IBD) in Chinese: Results From a Nationwide Population-Based Registry Siew C Ng, Wai K. Leung, Michael K. Li, Chi Man Leung, Yee Tak HUI, Carmen Ka Man Ng, Fu Hang Lo, Steve Tsang, Ching Kong Loo, Yiu Kay Chan, Kam Hon Chan, Aric J. Hui, Wai Hung Chow, Jessica Ching, Tiffany ML Chung, Catherine YY Iu, Marcus Harbord, Ivan Fan Ngai Hung, Wai Cheung Lao, Shun Fung Sze, Marc Tin Long Wong, Rita Leung, Vivian W. Tsang, Belsy Chung Yan Lam, Raymond Wai Hung Tong, Edwin Hok Shing Shan, Lai Yee Mak, Sai Ho Wong, Justin C. Wu, Francis K. L. Chan, Joseph J. Y. Sung
Table 1: Factors associated with initiation of IBD-specific medication following IBD diagnosis
Introduction: An inception cohort study in 2011 showed the incidence of inflammatory bowel disease (IBD) to be 3 per 100,000 in Hong Kong representing a three-fold increase in the past decade. We aimed to assess the prevalence and disease charactersitics of IBD in Hong Kong based on results from the Nixon-TAM Hong Kong IBD Registry. Methods: In a population-based cohort using both hospital and nation-wide administrative coding system, we identified 2,198 IBD patients from 13 hospitals within the Hong Kong IBD Registry. Detailed population data were obtained from the Hong Kong government's population estimates 2011 population census and disease phenotype was recorded based on Montreal classification. Results: The overall prevalence of IBD, ulcerative colitis (UC) and Crohn's disease (CD) in individuals aged 18 and over were 56, 34 and 21 per 100,000 people, respectively (Figure 1). Amongst 2,198 IBD subjects (1,337 UC, 826 CD, 35 unclassified), 59% were male, median age was 49 years [Interquartile range (IQR), 37-60)] and median disease duration was 9.1 years (IQR, 4.4-14.6). The prevalence of a family of IBD was low (2.7%). The prevalence of active smokers was 11.7% in CD and 7.7% in UC. Ileal, ileocolonic and colonic disease was reported in 25% 32% and 43% of CD patients, respectively. At diagnosis, complicated disease behavior (stricturing or penetrating diseases) was found in 38% and perianal disease in 25% of CD patients. Proctitis, left sided colitis and extensive/ total colitis were seen in 34%, 33% and 33%, respectively. 5-ASA use was common in UC (96%) and CD (90%). More CD than UC patients have ever used corticosteroids (75.4% vs 51.6%; p<0.05), immunosuppressants (75.2% vs 25.7%; p<0.001) and anti-TNF agents (15.6% vs 1.4%; p<0.001). Surgical rate was 32.9% in CD and 4.3% in UC. Overall mortality rate was low (0.8% in CD; 1.4% in UC). Conclusion: In the first population-based registry in Chinese, the prevalence of IBD in Hong Kong is lower than in Western countries, although comparable to that of other countries in East Asia. Complicated CD is not uncommon. Surgical and mortality rates remain low in Asians with IBD.
HR=Hazard Ratio; HR < 1.0 imply a lower likelihood of initiating IBD-specific medication after IBD diagnosis; CI=Confidence Interval; CCI=Charlson Comorbidity Index.
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AGA Abstracts
AGA Abstracts
Factors Associated With Delayed Initiation of IBD Medication and Becoming a Long-Term Nonuser of IBD-Specific Medications: A Population-Based Study Dessalegn Y. Melesse, Laura Targownik, Harminder Singh, James F. Blanchard, Charles N. Bernstein
Su1304
Background and Aims: We previously reported that approximately 40-50% of persons with IBD may not be using IBD-specific medications at any given time. In the current analysis, we evaluated potential factors associated with a delay in the initiation of any IBD-specific medication following diagnosis and factors associated with becoming a long-term nonuser (defined as no IBD-specific medications use for a year or longer) following the initiation of IBD-specific medications among a population based cohort of persons with IBD. Methods: All incident cases of IBD diagnosed between 1996 and 2012 were identified from the population-based University of Manitoba IBD Epidemiology Database. Study subjects were followed from diagnosis date until death, outmigration or end of database follow-up (March 31st, 2012). Comprehensive prescription drug data became available after 1995 and all dispensations since 1996 were used in the analysis. Cox proportional hazard models were used to identify factors associated with delayed initiation and with becoming a long-term nonuser of IBD-specific medication. Results: A total of 3902 subjects with IBD (47% male, 47% with Crohn's disease (CD)) were followed for an average duration of years after IBD diagnosis. Among those followed at least for 1 year, 5 years and 10 years after IBD diagnosis, approximately 11.7%, 6.2% and 4.1% were never dispensed any IBD-specific medication respectively. Persons with CD (HR=0.78; 95%CI: 0.73-0.83), of lower socio-economic status (SES ) (HR=0.91; 95%CI: 0.84-0.98), urbanites (HR=0.87, 95%CI: 0.82-0.93), age over 65 (HR=0.76; 95%CI: 0.67-0.86), and having any comorbidity were more likely to delay initiating first IBD-specific medication following diagnosis. Among subjects who were dispensed at least one IBD-specific medication following diagnosis (n=3708), persons with CD (HR=1.14; 95%CI: 1.04-1.25), of lower SES (HR=1.14, 95%CI: 1.02-1.27), being diagnosed in late 1990s or early 2000s, having had surgery (HR=1.72, 95%CI: 1.51-1.96), or delayed initiation of first IBD medication following diagnosis were more likely to become long-term nonusers after initiation. Conclusions and Relevance: Having CD, being of lower SES, being an urbanite, or having comorbidities were more likely to delay initiating IBD-specific medication. Persons with CD, of lower SES, having surgery, or having delayed initiation of first IBD-specific medication are associated with a greater likelihood of becoming a nonuser once IBD-specific medications were initiated. The longer patients wait to initiate IBD-specific medication following diagnosis, the poorer the adherence and quickly become long-term nonusers. Further work is required to evaluate the clinical implications of delayed initiation and long-term medication nonuse in IBD.
Su1303 Prevalence and Disease Characteristics of Inflammatory Bowel Disease (IBD) in Chinese: Results From a Nationwide Population-Based Registry Siew C Ng, Wai K. Leung, Michael K. Li, Chi Man Leung, Yee Tak HUI, Carmen Ka Man Ng, Fu Hang Lo, Steve Tsang, Ching Kong Loo, Yiu Kay Chan, Kam Hon Chan, Aric J. Hui, Wai Hung Chow, Jessica Ching, Tiffany ML Chung, Catherine YY Iu, Marcus Harbord, Ivan Fan Ngai Hung, Wai Cheung Lao, Shun Fung Sze, Marc Tin Long Wong, Rita Leung, Vivian W. Tsang, Belsy Chung Yan Lam, Raymond Wai Hung Tong, Edwin Hok Shing Shan, Lai Yee Mak, Sai Ho Wong, Justin C. Wu, Francis K. L. Chan, Joseph J. Y. Sung
Table 1: Factors associated with initiation of IBD-specific medication following IBD diagnosis
Introduction: An inception cohort study in 2011 showed the incidence of inflammatory bowel disease (IBD) to be 3 per 100,000 in Hong Kong representing a three-fold increase in the past decade. We aimed to assess the prevalence and disease charactersitics of IBD in Hong Kong based on results from the Nixon-TAM Hong Kong IBD Registry. Methods: In a population-based cohort using both hospital and nation-wide administrative coding system, we identified 2,198 IBD patients from 13 hospitals within the Hong Kong IBD Registry. Detailed population data were obtained from the Hong Kong government's population estimates 2011 population census and disease phenotype was recorded based on Montreal classification. Results: The overall prevalence of IBD, ulcerative colitis (UC) and Crohn's disease (CD) in individuals aged 18 and over were 56, 34 and 21 per 100,000 people, respectively (Figure 1). Amongst 2,198 IBD subjects (1,337 UC, 826 CD, 35 unclassified), 59% were male, median age was 49 years [Interquartile range (IQR), 37-60)] and median disease duration was 9.1 years (IQR, 4.4-14.6). The prevalence of a family of IBD was low (2.7%). The prevalence of active smokers was 11.7% in CD and 7.7% in UC. Ileal, ileocolonic and colonic disease was reported in 25% 32% and 43% of CD patients, respectively. At diagnosis, complicated disease behavior (stricturing or penetrating diseases) was found in 38% and perianal disease in 25% of CD patients. Proctitis, left sided colitis and extensive/ total colitis were seen in 34%, 33% and 33%, respectively. 5-ASA use was common in UC (96%) and CD (90%). More CD than UC patients have ever used corticosteroids (75.4% vs 51.6%; p<0.05), immunosuppressants (75.2% vs 25.7%; p<0.001) and anti-TNF agents (15.6% vs 1.4%; p<0.001). Surgical rate was 32.9% in CD and 4.3% in UC. Overall mortality rate was low (0.8% in CD; 1.4% in UC). Conclusion: In the first population-based registry in Chinese, the prevalence of IBD in Hong Kong is lower than in Western countries, although comparable to that of other countries in East Asia. Complicated CD is not uncommon. Surgical and mortality rates remain low in Asians with IBD.
HR=Hazard Ratio; HR < 1.0 imply a lower likelihood of initiating IBD-specific medication after IBD diagnosis; CI=Confidence Interval; CCI=Charlson Comorbidity Index.
S-467
AGA Abstracts
AGA Abstracts
Factors Associated With Delayed Initiation of IBD Medication and Becoming a Long-Term Nonuser of IBD-Specific Medications: A Population-Based Study Dessalegn Y. Melesse, Laura Targownik, Harminder Singh, James F. Blanchard, Charles N. Bernstein