Biological and Immunomodulator Use in Crohn's Disease in a Medicaid Population.

Inflamm Bowel Dis

*Division of Gastroenterology and Hepatology, University of Maryland School of Medicine, Baltimore, Maryland; †AbbVie Inc., North Chicago, Illinois; and ‡Analysis Group Inc., Boston, Massachusetts.

Published: May 2016

Background: Immunomodulator and biological use in African Americans (AA) with Crohn's disease (CD) has been reported to be lower than in whites (W); less data exist for Hispanics (H).

Methods: Medicaid databases from 3 states were examined for patients with CD from August 1998 to July 2009. CD-related treatments, comorbidities, location, surgery, and health care utilization were assessed from diagnosis until the first biological claim or end of claims. A Cox proportional hazard regression model was used to assess the effect of race on biological initiation.

Results: A total of 5575 patients with CD (3590 W; 924 AA; 494 H; and 567 "other") were analyzed; 18%, 17%, and 17% of W, AA, and H patients, respectively, started immunomodulators (P = not significant); and 7%, 9%, and 5% of W, AA, and H, respectively, initiated biologics after CD diagnosis (P = not significant). After adjusting for demographics and CD-related medications and comorbidities in Cox models, no association was found between AA and W for biological use (hazard ratio 1.19; 95% confidence interval [CI], 0.91-1.54) or H and W (hazard ratio 0.68, 95% CI, 0.45-1.02). Analyzing patients hospitalized after CD diagnosis (n = 3428) to adjust for disease severity demonstrated that H were significantly less likely to use biologics than W (hazard ratio 0.40, 95% CI, 0.22-0.74). No differences between W and AA were found.

Conclusions: Our findings suggest that differences between AA and W in exposure to immunomodulators or biologics may not exist, although they may be present in H with more severe disease. Further research is needed to confirm these findings.

Download full-text PDF

Source
http://dx.doi.org/10.1097/MIB.0000000000000730DOI Listing

Publication Analysis

Top Keywords

hazard ratio
12
crohn's disease
8
biological
5
biological immunomodulator
4
immunomodulator crohn's
4
disease
4
disease medicaid
4
medicaid population
4
population background
4
background immunomodulator
4

Similar Publications

Introduction: The purpose of this study was to evaluate the association between body composition, overall survival, odds of receiving treatment, and patient-reported outcomes (PROs) in individuals living with metastatic non-small-cell lung cancer (mNSCLC).

Methods: This retrospective analysis was conducted in newly diagnosed patients with mNSCLC who had computed-tomography (CT) scans and completed PRO questionnaires close to metastatic diagnosis date. Cox proportional hazard models and logistic regression evaluated overall survival and odds of receiving treatment, respectively.

View Article and Find Full Text PDF

Background: The Prognostic Nutritional Index (PNI), which reflects both nutritional and immune status, has emerged as a potential predictor of survival outcomes in cancer patients. However, its role in forecasting the prognosis of hepatocellular carcinoma (HCC) following curative hepatectomy remains unclear. To further investigate the association between PNI and survival outcomes in HCC patients, we conducted a systematic review and meta-analysis.

View Article and Find Full Text PDF

Background: Previous studies suggest that frailty increases the risk of mortality, but the risk of cardiovascular disease (CVD) and all-cause mortality in Chinese community-dwelling older adults remains understudied. Our aim was to explore the effect of frailty on cardiovascular and all-cause mortality in older adults based on a large-scale prospective survey of community-dwelling older adults in China.

Methods: We utilized the 2014-2018 cohort of the Chinese Longitudinal Healthy Longevity Survey and constructed a frailty index (FI) to assess frailty status.

View Article and Find Full Text PDF

Background: Although a few studies have examined the correlation between low-density lipoprotein cholesterol (LDL-C) and mortality, no study has explored these associations in hypertensive populations. This study aims to investigate the relationship between low-density lipoprotein cholesterol and cardiovascular and all-cause mortality in adults with hypertension.

Methods: Hypertensive participants aged ≥18 years from the National Health and Nutrition Examination Survey 1999-2018 with blood lipid testing data and complete follow-up data until 31 December 2019 were enrolled in the analysis.

View Article and Find Full Text PDF

Background: Predicting dementia early has major implications for clinical management and patient outcomes. Yet, we still lack sensitive tools for stratifying patients early, resulting in patients being undiagnosed or wrongly diagnosed. Despite rapid expansion in machine learning models for dementia prediction, limited model interpretability and generalizability impede translation to the clinic.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!