ArticleJGH open : an open access journal of gastroenterology and hepatology2019
Initial medical and surgical management of inflammatory bowel disease in the biologic era: A comparison between the United States and China.
Article in JGH open : an open access journal of gastroenterology and hepatology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 8 citations in OpenAlex.
- Symptoms of anxiety/depression is associated with more aggressive inflammatory bowel disease.Scientific reports · 2021Trial
- Global geoepidemiology of gastrointestinal surgery rates in Crohn's disease.World journal of gastrointestinal surgery · 2024Article
- Patients with Crohn's Disease Undergoing Abdominal Surgery: Clinical and Prognostic Evaluation Based on a Single-Center Cohort in China.World journal of surgery · 2022Observational
- Essential updates 2018/2019: Colorectal (benign): Recent updates (2018-2019) in the surgical treatment of benign colorectal diseases.Annals of gastroenterological surgery · 2020Article
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Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
Abstract
BACKGROUND AND
aimsWe compared the initial medical and surgical management of Crohn's disease (CD) and ulcerative colitis (UC) between the United States and China, with aims to better characterize the global variation in the treatment patterns of inflammatory bowel disease (IBD).
methodsParticipants from the United States and China completed a questionnaire on demographic and clinical characteristics, medications (biologics, immunomodulators, aminosalicylates, steroids), and IBD-related surgical history. Patients diagnosed in 2006 and later were eligible. Analysis was restricted to treatment patterns within 1 year of diagnosis. Multivariable logistic regressions examined differences by country.
resultsWe recruited 202 CD (US: 49%, China: 51%) and 133 UC (US: 63%, China: 37%) participants. Median age at survey was 31 years (range: 18-76) and at diagnosis was 28 years (range: 12-70). Biologics were commonly used in the United States for CD (66%) and UC (28%) and less commonly in China for CD (19%) and UC (0%). On regression, US CD participants were more likely to receive biologics (odds ratio [OR] 23.82 [95% confidence interval [CI] 8.98-63.14]), aminosalicylates (OR 4.93 [2.00-12.15]), and steroids (OR 4.36 [1.87-10.16]). US UC participants were more likely to receive immunomodulators (OR 3.45 [1.09-10.90]) and steroids (OR 3.31 [1.55-7.06]). There existed minimal differences regarding undergoing surgery for CD (US: 16%, China: 16%) and UC (US: 5%, China: 2%). A proportion (US: 12%, China: 19%) underwent IBD-related surgery prior to diagnosis (median: 5 years; range: 1-39).
conclusionUS, relative to Chinese, participants were more likely to report early biologic use. There were no differences between countries in undergoing early surgery. Evaluating global practice variation is integral to optimizing early pharmacological therapy and timing of surgery for patients with IBD.
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