Rising Rate of Obesity in Patients Admitted for Crohn’s Disease Increases Costs But Not Mortality

Lipcsey, Megan; Stein, Daniel J.; DeVore, Zachary; Feuerstein, Joseph D.

doi:10.1097/mcg.0000000000001421

Cited by 4 publications

(5 citation statements)

References 30 publications

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“…The association of weight loss with severe disease is well established for many years, however in recent years there have been reports on the negative impact of obesity on the disease course as well. [32][33][34][35] Although cannabis is not considered as a conventional treatment for IBD, many patients reported it as an effective treatment on the STW platform. There is some evidence to suggest that cannabis may have potential benefits in the treatment of CD.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, body build was significantly associated with disease severity, with either sided body build deviations being associated with a more severe disease course. The association of weight loss with severe disease is well established for many years, however in recent years there have been reports on the negative impact of obesity on the disease course as well 32–35 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Self‐reported treatment effectiveness for Crohn's disease using a novel crowdsourcing web‐based platform

Engel

Dotan

Synett³

et al. 2023

UEG Journal

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Background and AimsInternet and social media platforms have become an unprecedented source for sharing self‐experience, potentially allowing the collection and integration of health data with patient experience. StuffThatWorks (STW) is an online open platform that applies machine learning and the power of crowdsourcing, where patients with chronic medical conditions can self‐report and compare their individual outcomes using a structured online questionnaire. We aimed to conduct a cross‐sectional, international, crowdsourcing, artificial‐intelligence (AI) web‐based study of patients with Crohn's disease (CD) self‐reporting their outcomes.MethodsA proprietary STW Bayesian inference model was built to measure improvement in CD severity (on scale of 1–5) for each treatment and ranked treatments using effectiveness. The effectiveness of first‐line biological treatments was analyzed by multiple comparisons and by calculating odds ratios and 95% confidence intervals for each treatment pair.ResultsWe included 7593 self‐reported CD patients for the analysis. Most of the participants were female (75.8%) and from English‐speaking countries (95.7%). Overall, anti‐TNF drugs were the most reported tried treatment (52.8%). Infliximab (IFX) was ranked as the most effective treatment by the STW effectiveness model followed by bowel surgery (second), adalimumab (ADA, third), ustekinumab (UST, 4rd), and vedolizumab (VDZ, fifth). In paired comparison analyses, IFX was most effective, ADA had similar effectiveness compared to UST and all three were more effective than VDZ.ConclusionWe present the first online crowdsourcing AI platform‐based study of self‐reported treatment effectiveness in CD. Net‐based crowdsourcing patient‐reported outcome platforms can potentially help both clinicians and patients select the best treatment for their condition.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Self‐reported treatment effectiveness for Crohn's disease using a novel crowdsourcing web‐based platform

Engel

Dotan

Synett³

et al. 2023

UEG Journal

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“…In addition, we cannot comment on the validity or utility of proposed laboratory monitoring for PCP risk stratification among IBD patients, including T-lymphocyte counts [ 21 ], CD4 counts [ 21 ], and serum albumin levels [ 30 ]. Furthermore, the use of administrative coding poses the risk of diagnostic misclassification, although the use of ICD coding in IBD has been previously validated in a variety of contexts [ 33 - 36 ]. To further minimize this risk, only diagnostic codes specific for IBD were included, resulting in the potential exclusion of patients with undetermined IBD from our study.…”

Section: Discussionmentioning

confidence: 99%

Comprehensive National Inpatient Sample data reveals low but rising Pneumocystis jiroveci pneumonia risk in inflammatory bowel disease patients

Schwartz¹

2022

aog

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Background There are only limited data to guide the management of infectious risk for Pneumocystis jiroveci pneumonia (PCP) in patients with inflammatory bowel disease (IBD). We evaluated the frequency of admissions for PCP among patients with IBD, as well as the temporal trend in PCP admission rates and the contribution of non-IBD risk factors to the development of infection. Methods The National Inpatient Sample from 2016-2017 was queried for all admissions involving both PCP and either Crohn’s disease or ulcerative colitis. Inpatient outcomes associated with PCP and additive risk factors for development of PCP within the IBD patient population were assessed using multivariate regression. Linear regression was performed on data from 2002-2017 to measure infectious trends over time. Results There were an estimated 225 admissions involving PCP among patients with IBD from 2016-2017 nationwide, representing 0.035% of total admissions. IBD patients with PCP faced a 4.67-fold higher adjusted odds of inpatient mortality (95% confidence interval 1.72-12.66), while 49% of patients with IBD who developed PCP had an unrelated risk factor. The most common factors were HIV and congenital immunodeficiency, both of which were associated with PCP in adjusted regression. The infectious incidence of PCP increased by 141% from 2002 to 2017 (P=0.003). Conclusions National admissions data indicate that significant PCP is rare in IBD patients. Routine PCP prophylaxis is probably not necessary, although further study of high-risk subgroups of patients is required. The rising incidence of PCP indicates a need for continued surveillance.

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“…[8][9][10][11][12] The prevalence of excess weight and obesity among patients with IBD has increased greatly over recent decades. 13,14 The prevalence of obesity among patients with IBD has been estimated at 15% to 40%, with an additional 20% to 40% being classified as overweight. 11,14 The accumulation of adipose tissue, especially visceral fat, can increase the release of proinflammatory cytokines, which can negatively affect clinical and surgical outcomes.…”

Section: Introductionmentioning

confidence: 99%

Body Mass Index Profile of Adult Patients with Inflammatory Bowel Disease in a Multicenter Study in Northeastern Brazil

Lima,

Brito,

Celani

et al. 2023

CEG

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Inflammatory bowel disease (IBD) is a disease of increasing prevalence in developing countries. Obesity has emerged as a potential risk for IBD; however, the data in the literature are conflicting, and relevant studies in Brazil are limited. Here, we report body mass index profile (BMI) of patients with IBD treated at reference centers in three states of northeastern Brazil. Patients and Methods: Observational descriptive study conducted from January 2021 through December 2021 in patient with IBD. Results: Of 470 patients with IBD, 194 (41%) were classified as normal weight, 42 (9%) as underweight, 155 (33%) as overweight, and 79 (17%) as obese; CD patients were significantly more likely to be underweight than UC patients (p=0.031)Overweight patients were older (median age: 47 years) than normal-weight and underweight patients at diagnosis (38.5 and 35.5 years, respectively [p<0.0001]). IBD onset and diagnosis among overweight and obese individuals were associated with older age. More extensive disease behavior patterns predominated in UC, while forms associated with complications were prevalent in CD, irrespective of nutritional status. There was a higher frequency of compatible symptoms with axial joint inflammation among obese patients (p=0.005) and a lower frequency of compatible symptoms with peripheral joint inflammation in underweight patients (p=0.044) than in patients of normal weight. No significant difference in the frequency of different drug or surgical treatments was observed among the groups. Conclusion: Despite the predominance of overweight and obesity in patients with IBD, no differences in the patterns of disease were seen between the overweight and normal-weight groups; however, obesity was associated with IBD onset in older adults and a higher frequency compatible symptom with axial joint inflammation. These data reinforce the importance of monitoring the nutritional status of IBD patients and the need for a multidisciplinary approach, as recommended in the current guidelines.

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Rising Rate of Obesity in Patients Admitted for Crohn’s Disease Increases Costs But Not Mortality

Abstract: Supplemental Digital Content is available in the text.

Cited by 4 publications

References 30 publications

Self‐reported treatment effectiveness for Crohn's disease using a novel crowdsourcing web‐based platform

Self‐reported treatment effectiveness for Crohn's disease using a novel crowdsourcing web‐based platform

Comprehensive National Inpatient Sample data reveals low but rising Pneumocystis jiroveci pneumonia risk in inflammatory bowel disease patients

Body Mass Index Profile of Adult Patients with Inflammatory Bowel Disease in a Multicenter Study in Northeastern Brazil

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