The Crohnʼs and Colitis Foundation of America Survey of Inflammatory Bowel Disease Patient Health Care Access

Rubin, David T.; Feld, Lauren D.; Goeppinger, Sarah R.; Margolese, Joel; Rosh, Joel R.; Rubin, Michele; Kim, Sandra; Rodriquez, Dylan M.; Wingate, Laura

doi:10.1097/mib.0000000000000994

Cited by 33 publications

(15 citation statements)

References 15 publications

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“…Suboptimal biologic therapy was defined as the occurrence of at least one of these indicators, which were defined by the events listed below [20, 24–29]:…”

Section: Methodsmentioning

confidence: 99%

Indicators of suboptimal biologic therapy over time in patients with ulcerative colitis and Crohn's disease in the United States

Patel¹,

Lissoos

Rubin

2017

PLoS ONE

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This study assessed the occurrence of indicators for suboptimal biologic therapy among ulcerative colitis (UC) and Crohn’s disease (CD) patients over time in the United States (US). Data from a large US claims database (2005–2013) were used to retrospectively identify patients with diagnosed with either UC or CD who were new biologic users. Indicators of suboptimal biologic therapy included: dose escalation during the maintenance phase, discontinuation of the initial biologic, switch to another biologic within 90 days following the last day of supply of the initial biologic, augmentation with a non-biologic systemic therapy, UC- or CD-related surgery, UC- or CD-related urgent care, and development of fistula (for CD only). Kaplan-Meier analyses were used. A total of 1,699 UC and 4,569 CD patients were included. Among UC patients, 51.1% and 90.9% experienced ≥1 indicator of suboptimal biologic therapy within 6 months and 36 months of biologic therapy initiation, respectively. Among CD patients, 54.3% and 91.4% experienced ≥1 indicator of suboptimal biologic therapy within 6 and 36 months of biologic therapy initiation, respectively. For both UC and CD patients, the most frequent indicators of suboptimal biologic therapy were discontinuation, dose escalation and augmentation. In conclusion, this study found that the occurrence of suboptimal biologic therapy is common among patients with UC and CD, with approximately 90% of patients experiencing at least one indicator of suboptimal biologic therapy within 36 months of biologic treatment initiation.

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“…Suboptimal biologic therapy was defined as the occurrence of at least one of these indicators, which were defined by the events listed below [20, 24–29]:…”

Section: Methodsmentioning

confidence: 99%

Indicators of suboptimal biologic therapy over time in patients with ulcerative colitis and Crohn's disease in the United States

Patel¹,

Lissoos

Rubin

2017

PLoS ONE

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“…Crohn's disease (CD) is a chronic and sometimes debilitating form of inflammatory bowel disease characterized by inflammation, ulceration, and neutrophil influx in the intestinal epithelia [72]. The underlying cause of CD is unknown; however it is clear that both environmental and genetic factors are required for its development.…”

Section: Autophagy In Acute and Chronic Inflammatory Diseasementioning

confidence: 99%

Autophagy and inflammation

Qian

Fang

Wang

2017

Clinical & Translational Med

236

179

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Autophagy is a homeostatic mechanism involved in the disposal of damaged organelles, denatured proteins as well as invaded pathogens through a lysosomal degradation pathway. Recently, increasing evidences have demonstrated its role in both innate and adaptive immunity, and thereby influence the pathogenesis of inflammatory diseases. The detection of autophagy machinery facilitated the measurement of autophagy during physiological and pathophysiological processes. Autophagy plays critical roles in inflammation through influencing the development, homeostasis and survival of inflammatory cells, including macrophages, neutrophils and lymphocytes; effecting the transcription, processing and secretion of a number of cytokines, as well as being regulated by cytokines. Recently, autophagy‐dependent mechanisms have been studied in the pathogenesis of several inflammatory diseases, including infectious diseases, Crohn's disease, cystic fibrosis, pulmonary hypertension, chronic obstructive pulmonary diseases and so on. These studies suggested that modulation of autophagy might lead to therapeutic interventions for diseases associated with inflammation. Here we highlight recent advances in investigating the roles of autophagy in inflammation as well as inflammatory diseases.

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“…Prospective studies of issues of access to care were undertaken by the Crohn's and Colitis Foundation. 114 Direct assessments of patients' views on access can be used in real-world analyses of disparities in access; patients could be directly asked questions such as: how often do you use an alternative medication because you cannot see your physician? How often do you delay filling a medication because of cost (or insurance coverage)?…”

Section: Improving Access To Carementioning

confidence: 99%

Effects of Race and Ethnicity on Diagnosis and Management of Inflammatory Bowel Diseases

2021

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Although Crohn's disease (CD) and ulcerative colitis (UC) have been considered as disorders that affect individuals of European ancestry, the epidemiology of the inflammatory bowel diseases (IBDs) is changing. Coupled with the increasing incidence of IBD in previously low-incidence areas, the population demographics of IBD in the United States are also changing, with increases among non-White races and ethnicities. It is therefore important to fully understand the epidemiology and progression of IBD in different racial and ethnic groups, and the effects of race and ethnicity on access to care, use of resources, and disease-related outcomes. We review differences in IBD development and progression among patients of different races and ethnicities, discussing the effects of factors such as access to care, delays in diagnosis, and health and disease perception on disparities in IBD care and outcomes. We identify research priorities for improving health equity among minority patients with IBD.

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The Crohnʼs and Colitis Foundation of America Survey of Inflammatory Bowel Disease Patient Health Care Access

Cited by 33 publications

References 15 publications

Indicators of suboptimal biologic therapy over time in patients with ulcerative colitis and Crohn's disease in the United States

Indicators of suboptimal biologic therapy over time in patients with ulcerative colitis and Crohn's disease in the United States

Autophagy and inflammation

Effects of Race and Ethnicity on Diagnosis and Management of Inflammatory Bowel Diseases

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