P553 Factors related to steroid consumption in IBD patients: Evidence from a multicenter Study

Barkan, Revital; Shpoker, L; Abboud, Rami; Nafrin, Smadar; Ganon, Miriam; Ilsar, T; Volf, T; Markovitch, Lizy; Sabán, Maria Isabel Ojanguren; Kagan, I. I.

doi:10.1093/ecco-jcc/jjab076.674

Cited by 1 publication

(1 citation statement)

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“…A total of 13 studies (19.4%) examined corticosteroid use [36,42,45,59,64,70,72,75,[85][86][87][88][89] (Table 3), of which only 2 studies (15.4%) reported a statistically significant sex-based difference in the use of corticosteroids, with fewer male patients using a corticosteroid (budesonide) than female patients for both CD and UC in one study [64] and fewer female patients using steroids for total IBD patients in the other study [89].…”

Section: Use Of Corticosteroidsmentioning

confidence: 99%

Impact of sex and socioeconomic status on the likelihood of surgery, hospitalization, and use of medications in inflammatory bowel disease: a systematic review and meta-analysis

Rasmussen,

Moos,

Gregersen

et al. 2024

Syst Rev

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Background Inflammatory bowel diseases (IBDs) are associated with high healthcare utilization. This systematic review aimed to summarize what is known about the impact of sex, income, and education on the likelihood of bowel surgery, hospitalization, and use of corticosteroids and biologics among patients with IBD. Methods We used EMBASE, MEDLINE, CINAHL, and Web of Science to perform a systematic literature search. Pooled hazard ratios (HRs) and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random effects meta-analysis for the impact of sex on the likelihood of surgery and hospitalization. In addition, we performed subgroup analyses of the effect of IBD type (Crohn’s disease or ulcerative colitis) and age. Finally, meta-regression was undertaken for the year of publication. Results In total, 67 studies were included, of which 23 studies were eligible for meta-analysis. In the main meta-analysis, male sex was associated with an increased likelihood of bowel surgery (HR 1.42 (95% CI 1.13;1.78), which was consistent with the subgroup analysis for UC only (HR 1.78, 95% CI 1.16; 2.72). Sex did not impact the likelihood of hospitalization (OR 1.05 (95% CI 0.86;1.30), although the subgroup analysis revealed an increased likelihood of hospitalization in CD patients (OR 1.42, 95% CI 1.28;1.58). In 9 of 10 studies, no significant sex-based differences in the use of biologics were reported, although in 6 of 6 studies, female patients had lower adherence to biologics. In 11 of 13 studies, no significant sex-based difference in the use of corticosteroids was reported. The evidence of the impact of income and education on healthcare utilization was sparse and pointed in different directions. The substantial heterogeneity between studies was explained, in part, by differences in IBD type and age. Conclusions The results of this systematic review indicate that male patients with IBD are significantly more likely to have surgery than female patients with IBD but are not, overall, more likely to be hospitalized, whereas female patients appear to have statistically significantly lower adherence to biologics compared to male patients. Thus, clinicians should not underestimate the impact of sex on healthcare utilization. Evidence for income- and education-based differences remains sparse. Systematic review registration PROSPERO CRD42022315788.

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