Treatment adaptations and outcomes of patients experiencing inflammatory bowel disease flares during the early COVID-19 pandemic: the PREPARE-IBD multicentre cohort study
Authors
Saifuddin, AamirKent, Alexandra
Mehta, Shameer
Hicks, Lucy
Gonzalez, Haidee A
Segal, Jonathan P.
Brookes, Matthew
Subramanian, Sreedhar
Bhala, Neeraj
Conley, Thomas E
Patel, Kamal V
PREPARE-IBD Collaborators
Lamb, Christopher A
Walker, Gareth J
Kennedy, Nicholas A
Sebastian, Shaji
Issue Date
2022-10-05
Metadata
Show full item recordAbstract
Background: The COVID-19 pandemic offered a unique opportunity to understand inflammatory bowel disease (IBD) management during unexpected disruption. This could help to guide practice overall. Aims: To compare prescribing behaviour for IBD flares and outcomes during the early pandemic with pre-pandemic findings. Methods: We performed an observational cohort study comprising patients who contacted IBD teams for symptomatic flares between March and June 2020 in 60 National Health Service trusts in the United Kingdom. Data were compared with a pre-pandemic cohort after propensity-matching for age and physician global assessment of disease activity. Results: We included 1864 patients in each of the pandemic and pre-pandemic cohorts. The principal findings were reduced systemic corticosteroid prescription during the pandemic in Crohn's disease (prednisolone: pandemic 26.5% vs. 37.1%; p < 0.001) and ulcerative colitis (UC) (prednisolone: pandemic 33.5% vs. 40.7%, p < 0.001), with increases in poorly bioavailable oral corticosteroids in Crohn's (pandemic 15.6% vs. 6.8%; p < 0.001) and UC (pandemic 11.8% vs. 5.2%; p < 0.001). Ustekinumab (Crohn's and UC) and vedolizumab (UC) treatment also significantly increased. Three-month steroid-free remission in each period was similar in Crohn's (pandemic 28.4% vs. 32.1%; p = 0.17) and UC (pandemic 36.4% vs. 40.2%; p = 0.095). Patients experiencing a flare and suspected COVID-19 were more likely to have moderately-to-severely active disease at 3 months than those with a flare alone. Conclusions: Despite treatment adaptations during the pandemic, steroid-free outcomes were comparable with pre-pandemic levels, although concurrent flare and suspected COVID-19 caused worse outcomes. These findings have implications for IBD management during future pandemics and for standard practice.Citation
Saifuddin, A., Kent, A.J., Mehta, S.J., Hicks, L.C., Gonzalez, H.A., Segal, J.P., Brookes, M.J., Subramanian, S., Bhala, N., Conley, T.E., Patel, K., PREPARE-IBD Collaborators, Lamb, C.A., Walker, G.J., Kennedy, N.A., Sebastian, S. (2022) Treatment adaptations and outcomes of patients experiencing inflammatory bowel disease flares during the early COVID-19 pandemic: the PREPARE-IBD multicentre cohort study. Alimentary Pharmacology and Therapeutics , 56 (10) pp. 1460-1474.Publisher
WileyJournal
Alimentary Pharmacology and TherapeuticsPubMed ID
36196569 (pubmed)Additional Links
https://onlinelibrary.wiley.com/doi/10.1111/apt.17223Type
Journal articleLanguage
enDescription
This is an accepted manuscript of an article published by Wiley on 05/10/2022, available online: https://doi.org/10.1111/apt.17223 The accepted manuscript may differ from the final published version.ISSN
0269-2813EISSN
1365-2036ae974a485f413a2113503eed53cd6c53
10.1111/apt.17223
Scopus Count
Collections
Except where otherwise noted, this item's license is described as https://creativecommons.org/licenses/by-nc-nd/4.0/
Related articles
- Treatment adaptations and outcomes of patients experiencing inflammatory bowel disease flares during the early COVID-19 pandemic: the PREPARE-IBD multicentre cohort study.
- Authors: Saifuddin A, Kent AJ, Mehta SJ, Hicks LC, Gonzalez HA, Segal JP, Brookes MJ, Subramanian S, Bhala N, Conley TE, Patel KV, PREPARE-IBD Collaborators, Lamb CA, Walker GJ, Kennedy NA, Sebastian S
- Issue date: 2022 Nov
- COVID-19 Does Not Lead to an Increase in Corticosteroid Prescriptions in IBD Patients: A Nationwide Cohort Study.
- Authors: Nørgård BM, Zegers FD, Nielsen J, Knudsen T, Kjeldsen J
- Issue date: 2023 Sep 1
- Comparison of Disease Phenotype and Course among Elderly- and Early-Onset Inflammatory Bowel Diseases in the Middle East.
- Authors: Vosoghinia H, Saberzadeh-Ardestani B, Anushiravani A, Mansour-Ghanaei F, Fakheri H, Vahedi H, Sheikhesmaeili F, Yazdanbod A, Moosavy SH, Maleki I, Nasseri-Moghaddam S, Khosravi B, Malekzadeh M, Kasaeian A, Alatab S, Sadeghi A, Kolahdoozan S, Amani M, Saberhosseini SN, Rayatpisheh M, Ahadi M, Colombel JF, Ungaro RC, Sima AR, Malekzadeh R
- Issue date: 2023 Sep 1
- Disease Flares Following COVID-19 Vaccination in Patients with Inflammatory Bowel Disease.
- Authors: Yoshida Y, Fujioka S, Moriyama T, Umeno J, Kawasaki K, Fuyuno Y, Matsuno Y, Ihara Y, Torisu T, Kitazono T
- Issue date: 2023 Dec 15