Epidemiology and Treatment Patterns of Fistulizing Crohn’s Disease in a Large, Real-World Australasian Cohort
Background and Aims: Fistulizing Crohn’s Disease (fCD) affects up to 50% of people with Crohn’s Disease over their lifetime. Despite this high prevalence, the burden of disease, treatment and natural history in the current biologic era are poorly described. This study explores demographic, disease a...
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Elsevier
2025-01-01
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| Series: | Gastro Hep Advances |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772572324001900 |
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| author | Jack McNamara William Wilson Joseph L. Pipicella Simon Ghaly Jakob Begun Ian C. Lawrance Richard Gearry Jane M. Andrews Susan J. Connor |
| author_facet | Jack McNamara William Wilson Joseph L. Pipicella Simon Ghaly Jakob Begun Ian C. Lawrance Richard Gearry Jane M. Andrews Susan J. Connor |
| author_sort | Jack McNamara |
| collection | DOAJ |
| description | Background and Aims: Fistulizing Crohn’s Disease (fCD) affects up to 50% of people with Crohn’s Disease over their lifetime. Despite this high prevalence, the burden of disease, treatment and natural history in the current biologic era are poorly described. This study explores demographic, disease and treatment factors in a real-world Australasian cohort. Methods: A large real-world cohort of people with inflammatory bowel disease under routine care was interrogated in August 2023. Current fCD was defined as fistula(e) on most recent clinical, radiologic or endoscopic investigation; prior fCD was defined as the resolution of fistula(e) on most recent documentation. Results: Of 3075 people with Crohn’s Disease, 7.4% had current and 10.1% prior fCD (n = 224 & 311). Most patients were in Australia (77%), where 19.3% had current or previous fCD compared to 11% in New Zealand (P < .001). Patients with current or previous fCD were younger compared to those without (P = .003 & P < .001). Males were more commonly affected (P = .021). Current or prior fCD were more likely to be on biologic therapy (P < .001), with anti-tumor necrosis factor agents most frequently utilized. Conversely, those without fCD were more likely on Ustekinumab or Vedolizumab compared to current and prior fCD groups. People with fistulizing disease had higher hospitalization rates, while the prior fCD cohort had longer hospital admissions and more frequently required surgical intervention. Conclusion: People with fCD used more health-care resources, making this an important area for further research into care gaps to improve outcomes and optimal treatment approaches. |
| format | Article |
| id | doaj-art-44186594c9a24c84b5c3d21b0524b099 |
| institution | Kabale University |
| issn | 2772-5723 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Gastro Hep Advances |
| spelling | doaj-art-44186594c9a24c84b5c3d21b0524b0992025-02-08T05:01:41ZengElsevierGastro Hep Advances2772-57232025-01-0144100594Epidemiology and Treatment Patterns of Fistulizing Crohn’s Disease in a Large, Real-World Australasian CohortJack McNamara0William Wilson1Joseph L. Pipicella2Simon Ghaly3Jakob Begun4Ian C. Lawrance5Richard Gearry6Jane M. Andrews7Susan J. Connor8Liverpool Hospital Department of Gastroenterology & Hepatology, Sydney, NSW, Australia; Ingham Institute for Applied Medical Research, Gastroenterology, Hepatology and Inflammatory Bowel Disease Research Group, Liverpool, NSW, Australia; Correspondence: Address correspondence to: Jack McNamara, Department of Gastroenterology & Hepatology Liverpool Hospital, Elizabeth Drive, Liverpool, NSW 2170, Australia.Lyell McEwin Hospital, Adelaide, SA, AustraliaIngham Institute for Applied Medical Research, Gastroenterology, Hepatology and Inflammatory Bowel Disease Research Group, Liverpool, NSW, Australia; Crohn’s Colitis Cure, Sydney, NSW, Australia; Medicine & Health (South Western Sydney Clinical School), University of New South Wales, Sydney, NSW, AustraliaDepartment of Gastroenterology, St Vincent’s Hospital, Sydney, NSW, Australia; St Vincent’s Clinical School, University of New South Wales, Sydney, NSW, AustraliaDepartment of Gastroenterology, Mater Hospital, Brisbane, QLD, Australia; Faculty of Medicine, University of Queensland, St Lucia, QLD, AustraliaCrohn’s Colitis Cure, Sydney, NSW, Australia; School of Medicine, University of Western Australia, Crawley, WA, AustraliaDepartment of Medicine, University of Otago, Christchurch, New ZealandCrohn’s Colitis Cure, Sydney, NSW, Australia; Central Adelaide Local Health Network, Adelaide, SA, Australia; University of Adelaide Faculty of Health Sciences, Adelaide, SA, AustraliaLiverpool Hospital Department of Gastroenterology & Hepatology, Sydney, NSW, Australia; Ingham Institute for Applied Medical Research, Gastroenterology, Hepatology and Inflammatory Bowel Disease Research Group, Liverpool, NSW, Australia; Crohn’s Colitis Cure, Sydney, NSW, Australia; Medicine & Health (South Western Sydney Clinical School), University of New South Wales, Sydney, NSW, AustraliaBackground and Aims: Fistulizing Crohn’s Disease (fCD) affects up to 50% of people with Crohn’s Disease over their lifetime. Despite this high prevalence, the burden of disease, treatment and natural history in the current biologic era are poorly described. This study explores demographic, disease and treatment factors in a real-world Australasian cohort. Methods: A large real-world cohort of people with inflammatory bowel disease under routine care was interrogated in August 2023. Current fCD was defined as fistula(e) on most recent clinical, radiologic or endoscopic investigation; prior fCD was defined as the resolution of fistula(e) on most recent documentation. Results: Of 3075 people with Crohn’s Disease, 7.4% had current and 10.1% prior fCD (n = 224 & 311). Most patients were in Australia (77%), where 19.3% had current or previous fCD compared to 11% in New Zealand (P < .001). Patients with current or previous fCD were younger compared to those without (P = .003 & P < .001). Males were more commonly affected (P = .021). Current or prior fCD were more likely to be on biologic therapy (P < .001), with anti-tumor necrosis factor agents most frequently utilized. Conversely, those without fCD were more likely on Ustekinumab or Vedolizumab compared to current and prior fCD groups. People with fistulizing disease had higher hospitalization rates, while the prior fCD cohort had longer hospital admissions and more frequently required surgical intervention. Conclusion: People with fCD used more health-care resources, making this an important area for further research into care gaps to improve outcomes and optimal treatment approaches.http://www.sciencedirect.com/science/article/pii/S2772572324001900Crohn’s DiseaseColitisFistulaBiologic Therapy |
| spellingShingle | Jack McNamara William Wilson Joseph L. Pipicella Simon Ghaly Jakob Begun Ian C. Lawrance Richard Gearry Jane M. Andrews Susan J. Connor Epidemiology and Treatment Patterns of Fistulizing Crohn’s Disease in a Large, Real-World Australasian Cohort Gastro Hep Advances Crohn’s Disease Colitis Fistula Biologic Therapy |
| title | Epidemiology and Treatment Patterns of Fistulizing Crohn’s Disease in a Large, Real-World Australasian Cohort |
| title_full | Epidemiology and Treatment Patterns of Fistulizing Crohn’s Disease in a Large, Real-World Australasian Cohort |
| title_fullStr | Epidemiology and Treatment Patterns of Fistulizing Crohn’s Disease in a Large, Real-World Australasian Cohort |
| title_full_unstemmed | Epidemiology and Treatment Patterns of Fistulizing Crohn’s Disease in a Large, Real-World Australasian Cohort |
| title_short | Epidemiology and Treatment Patterns of Fistulizing Crohn’s Disease in a Large, Real-World Australasian Cohort |
| title_sort | epidemiology and treatment patterns of fistulizing crohn s disease in a large real world australasian cohort |
| topic | Crohn’s Disease Colitis Fistula Biologic Therapy |
| url | http://www.sciencedirect.com/science/article/pii/S2772572324001900 |
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