Occurrence of inflammatory bowel disease in central Italy: A study based on health information systems

Domenicantonio, Riccardo Di; Cappai, Giovanna; Arcà, Massimo; Agabiti, Nera; Kohn, Anna; Vernia, Piero; Biancone, Livia; Armuzzi, Alessandro; Papi, Claudio; Davoli, Marina

doi:10.1016/j.dld.2014.04.014

Cited by 47 publications

(36 citation statements)

References 15 publications

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“…The proportion of patients was similar to that previously reported in other pediatric observations in whom IBD-U accounts for 10% to 15% of newly diagnosed patients with IBD[8,15,20,25,30,31,36,40], but other researchers have reported a somewhat lower incidence of IBD-U[22,29,41]. Undoubtedly, our data parallel observations obtained in adults[11,34,42,43]. This is a partially unexplained phenomenon.…”

Section: Discussionsupporting

confidence: 91%

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Inflammatory bowel disease incidence in Czech children: A regional prospective study, 2000-2015

Schwarz

Sýkora

Cvalínová

et al. 2017

WJG

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AIMTo examine the incidence and trends in pediatric inflammatory bowel diseases (IBDs) over 2000-2015 and project the incidence to 2018.METHODSA 16-year prospective study of IBD patients < 19 years of age was conducted in the Czech Republic (the Pilsen region). All incident IBD cases within a well-defined geographical area were retrieved from a prospectively collected computerized clinical database. Historical Czech data were used for comparison (1990-2001). Our catchment population was determined from the census data. We calculated the incidence by relating the number of newly diagnosed cases to the size of the pediatric population-at-risk in each calendar year. Age/sex, disease type, place of residence, and race/ethnicity were identified.RESULTSIn total, 170 new IBD cases [105 Crohn’s disease (CD), 48 ulcerative colitis (UC), and 17 IBD-unclassified (IBD-U)] were identified. The median age at IBD diagnosis was 14.2 years, 59.4% were males, and 97.1% were Caucasians. A male preponderance of IBD (P = 0.026) and CD (P = 0.016) was observed. With 109209 person-years in the catchment area, the average incidence of IBD per 100000 person-years was 10.0 (6.2 for CD, 2.8 for UC, and 1.0 for IBD-U) for children aged 0 to 19 years; for those aged 0 to 15 years, the incidence rate was 7.3 (4.6 for CD, 2.0 for UC, and 0.7 for IBD-U). An increase in incidence with age was observed (P = 0.0003). Over the 16-year period, the incidence increased for IBD patients (P = 0.01) and CD in particular (P < 0.0001), whereas the incidence for UC (P = 0.09) and IBD-U (P = 0.339) remained unchanged. IBD-projected data from 2016 to 2018 were 12.1, 12.3 and 12.6 per 100000 person-years, respectively.CONCLUSIONPediatric-onset IBD incidence is around its highest point. The increase, which is particularly pronounced for CD, may be challenging to relate to causes of pediatric disease.

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Section: Discussionsupporting

confidence: 91%

“…In contrast, Castro et al[30] showed that UC was more prevalent than CD in Italian children. An equal incidence of UC and CD occurs among adult populations[33], whereas the incidence of UC was approximately 2-fold higher than the incidence of CD in the Lazio region in Italy[34]. …”

Section: Discussionmentioning

confidence: 99%

Inflammatory bowel disease incidence in Czech children: A regional prospective study, 2000-2015

Schwarz

Sýkora

Cvalínová

et al. 2017

WJG

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“…Population-based studies are preferable to monitor disease epidemiology, comorbidities and care pathways, but also to describe the burden of this disease and to plan its prevention, treatment, as well as the management strategies and resource allocation necessary to cope with it [19,20]. Administrative data offer a unique opportunity to study the population-based prevalence of chronic diseases such as MS [19,21,22,23,24,25,26,27,28,29], or Parkinson's disease [30].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Multiple Sclerosis in Tuscany (Central Italy): A Study Based on Validated Administrative Data

Battaglia

Policardo²,

Meucci³

et al. 2015

Neuroepidemiology

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Background: Multiple Sclerosis (MS) epidemiology in Italy is mainly based on population-based prevalence studies. Administrative data are an additional source of information, when available, in prevalence studies of chronic diseases such as MS. The aim of our study is to update the prevalence rate of MS in Tuscany (central Italy) as at 2011 using a validated case-finding algorithm based on administrative data. Methods: The prevalence was calculated using an algorithm based on the following administrative data: hospital discharge records, drug-dispensing records, disease-specific exemptions from copayment to health care, home and residential long-term care and inhabitant registry. To test algorithm sensitivity, we used a true-positive reference cohort of MS patients from the Tuscan MS register. To test algorithm specificity, we used another cohort of individuals who were presumably not affected by MS. Results: As at December 31, 2011, we identified 6,890 cases (4,738 females and 2,152 males) with a prevalence of 187.9 per 100,000. The sensitivity of algorithm was 98% and the specificity was 99.99%. Conclusions: We found a prevalence higher than the rates present in literature. Our algorithm, based on administrative data, can accurately identify MS patients; moreover, the resulting cohort is suitable to monitor disease care pathways.

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“…In Italy, few data exist about the use of biologics for IBD due to a lack of a national database. Assuming a population of 60 483 973 inhabitants and a prevalence of 160 per 100 000 for UC and 90 per 100 000 for CD, we estimate that in Italy around 97 000 people have UC and around 54 000 people have CD. A 2015 paper reported that, in Italy, 2499 UC patients and 2,188 CD patients were being treated with infliximab; these numbers correspond to about 2.5% and 4.0%, respectively, of all Italian UC and CD patients.…”

Section: Introductionmentioning

confidence: 99%

Barriers to anti‐TNFalpha prescription among Italian physicians managing inflammatory bowel disease

Bezzio¹,

Imperatore

Armuzzi

et al. 2019

GastroHep

Self Cite

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Summary Background Italian physicians managing IBD patients seem to prescribe anti‐TNFalpha agents less frequently than physicians in other countries. Aims To investigate reasons and situations that limit the use of these medications. Methods A questionnaire was distributed to 600 physicians attending IG‐IBD events. Results Two hundred eighty physicians (46.7%) completed the questionnaire. Most physicians (76.2%) prescribed anti‐TNFalpha every time one was needed, however, 12.6% were limited by budget, 8.1% lacked confidence, 2.2% lacked permission and 0.9% chose not to prescribe them. The limitations in using anti‐TNFalpha were: fear of side effects (39.1%), costs (38.2%), administrative/bureaucratic limitations (8.0%) and lack of staff (6.2%). The main feared side effects include: opportunistic infection (45.7%), neoplasms (25.4%), allergic reactions (12.5%), reactivation of tuberculosis (7.3%) and onset of autoimmune disease (7.3%). Physicians younger than 45 years of age and with less than 15 years of clinical experience were more likely to prescribe anti‐TNFalpha than older physicians (70.8% vs 57.1%; P = 0.022) than more experienced physicians (71.2% vs 58.9%; P = 0.033). Conclusions The apparent underuse of anti‐TNFalpha in Italy can be attributed mainly to physicians’ fears of side effects, concerns about costs and scarce familiarity with these drugs. Addressing these barriers may lead to an improvement in the quality of assistance to IBD patients.

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Occurrence of inflammatory bowel disease in central Italy: A study based on health information systems

Cited by 47 publications

References 15 publications

Inflammatory bowel disease incidence in Czech children: A regional prospective study, 2000-2015

Inflammatory bowel disease incidence in Czech children: A regional prospective study, 2000-2015

Prevalence of Multiple Sclerosis in Tuscany (Central Italy): A Study Based on Validated Administrative Data

Barriers to anti‐TNFalpha prescription among Italian physicians managing inflammatory bowel disease

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