PhD Scientific Days 2017

Oral Presentations: Clinical Sciences

Therapeutic preferences and outcomes in newly diagnosed patient with Crohn's diseases in the biological era in Hungary. A nationwide study based on the National Health Insurance Fund database

Előadó neve

Kürti, Zsuzsanna

Előadó munkahelye

First Department of Medicine, Semmelweis University, Budapest

Előadó telefonszáma

06302826442

Előadó e-mail címe

zsuzsa.kurti@gmail.com

Az előadás címe

Therapeutic preferences and outcomes in newly diagnosed patient with Crohn's diseases in the biological era in Hungary. A nationwide study based on the National Health Insurance Fund database

Szerző(k) neve és munkahelye

Zsuzsanna Kurti1, Lorant Gonczi1, Zsuzsanna Vegh1, Petra A Golovics1, Petra Fadgyas-Freyler2, Judit Gimesi-Orszagh2, Gyula Korponay2, Barbara D Lovasz1, Peter L Lakatos1
1 1st Department of Medicine, Semmelweis University, Budapest, Hungary
2 Strategic Analysis Department, National Health Insurance Fund (OEP), Budapest, Hungary

Szekció

Oral Presentations: Clinical Sciences

Data of the presenter

2. Clinical Medicine Doctoral School
15. program
Supervisor: Peter Laszlo Lakatos MD, PhD, DsC
zsuzsa.kurti@gmail.com
oral presentation
(preferred section: clinical science, gastroenterology section!)

Text of the abstract

Background
Accelerated treatment strategy, including tight disease control and early aggressive therapy with immunosuppressives (IS) and biological agents have become increasingly common in inflammatory bowel disease (IBD).
Aim
To estimate the early treatment strategy and outcomes in newly diagnosed Crohn’s disease (CD) patients between 2004-2009 and 2009-2015 in the whole IBD population in Hungary based on the administrative database of the National Health Insurance Fund (OEP).
Methods
We used the administrative database of the OEP, the only nationwide state-owned health insurance provider in Hungary. Patients were identified using the ICD-10 codes for CD in the out-,inpatient (medical, surgical) non-primary care records and drug prescription databases between 2004-2015. Patients were stratified according to the year of diagnosis and maximum treatment step during the first 3-years after the diagnosis.
Results
A total of 6173(male/female:46.12%/53.87%) newly diagnosed CD patients with physician-diagnosed IBD were found in this period. Rate of maximum treatment step did not differ before and after 2009 (5-ASA:11.7%vs.13.5%,Steroid:31%vs.30.5%,IM:40.4%vs.40.2%,biological:16.5%vs.15.6%). Probability of hospitalizations in the first 3-years after the diagnosis according to the maximal treatment step was different before and after 2009 (at 36x30-day: anti-TNF:73%vs.66.7%(p=0.103), IS:64.6%vs.56.1%(p=0.000), steroid:44.2%vs.36.8%(p<0.007), 5-ASA:32.6%vs.26.7%p=0.157)), respectively. In contrast, surgery rates were not significantly different in patients diagnosed before and after 2009 according to the maximum treatment step (at 36x30-day: overall 16.0%vs.15.3%(p= 0.672) anti-TNF 26,7%vs.27.2%(p=0.993), IS: 24.1%vs.22.2%(p=0.565), steroid 8.1%vs.7.9%(p=0.896), 5-ASA 10%vs.11%(p=0.816))
Conclusions
The rate of maximal treatment steps and surgery rates did not differ significantly in the two diagnostic period, although the adjustment of IS and biological therapy started earlier after 2009. Use of steroid and 5-ASA remained common after 2009. Maximal treatment steps correlated with hospitalization and surgery rates, suggesting that maximal treatment steps can be used as proxy severity marker in patients with IBD. Hospitalization rates during the first 3-years after the diagnosis decreased in all treatment groups, suggesting a change in the patient management.

Kind

Szabad

Előadás fájl jóváhagyás

nem rendelkezett róla

Előadó

1005

Authors (legacy)

Zsuzsanna Kurti1, Lorant Gonczi1, Zsuzsanna Vegh1, Petra A Golovics1, Petra Fadgyas-Freyler2, Judit Gimesi-Orszagh2, Gyula Korponay2, Barbara D Lovasz1, Peter L Lakatos1
1 1st Department of Medicine, Semmelweis University, Budapest, Hungary
2 Strategic Analysis Department, National Health Insurance Fund (OEP), Budapest, Hungary