{Reference Type}: Journal Article
{Title}: Intestinal complications in patients with Crohn's disease in the Brazilian public healthcare system between 2011 and 2020.
{Author}: Sassaki LY;Martins AL;Galhardi-Gasparini R;Saad-Hossne R;Ritter AMV;Barreto TB;Marcolino T;Balula B;Yang-Santos C;
{Journal}: World J Clin Cases
{Volume}: 11
{Issue}: 14
{Year}: 2023 May 16
{Factor}: 1.534
{DOI}: 10.12998/wjcc.v11.i14.3224
{Abstract}: <B>BACKGROUND: </B>This is a secondary database study using the Brazilian public healthcare system database.<BR><B>OBJECTIVE: </B>To describe intestinal complications (ICs) of patients in the Brazilian public healthcare system with Crohn's disease (CD) who initiated and either only received conventional therapy (CVT) or also initiated anti-tumor necrosis factor (anti-TNF) therapy between 2011 and 2020.<BR><B>METHODS: </B>This study included patients with CD [international classification of diseases - 10th revision (ICD-10): K50.0, K50.1, or K50.8] (age: ≥ 18 years) with at least one claim of CVT (sulfasalazine, azathioprine, mesalazine, or methotrexate). IC was defined as a CD-related hospitalization, pre-defined procedure codes (from rectum or intestinal surgery groups), and/or associated disease (pre-defined ICD-10 codes), and overall (one or more type of ICs).<BR><B>RESULTS: </B>In the 16809 patients with CD that met the inclusion criteria, the mean follow-up duration was 4.44 (2.37) years. In total, 14697 claims of ICs were found from 4633 patients. Over the 1- and 5-year of follow-up, 8.3% and 8.2% of the patients with CD, respectively, presented at least one IC, of which fistula (31%) and fistulotomy (48%) were the most commonly reported. The overall incidence rate (95%CI) of ICs was 6.8 (6.5-7.04) per 100 patient years for patients using only-CVT, and 9.2 (8.8-9.6) for patients with evidence of anti-TNF therapy.<BR><B>CONCLUSIONS: </B>The outcomes highlighted an important and constant rate of ICs over time in all the CD populations assessed, especially in patients exposed to anti-TNF therapy. This outcome revealed insights into the real-world treatment and complications relevant to patients with CD and highlights that this disease remains a concern that may require additional treatment strategies in the Brazilian public healthcare system.