Hospitalisations and surgery in Crohn's disease
Hospitalisations and surgery in Crohn's disease
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DOI：
10.1136/gutjnl-2011-301397
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发表时间：
2012-04-01
期刊：
影响因子：
24.5
通讯作者：
Moum, Bjorn
中科院分区：
文献类型：
--
作者：
Bernstein, Charles N.;Loftus, Edward V., Jr.;Moum, Bjorn
住院和手术被认为是克罗恩病更严重疾病的标志。这些都是昂贵的事件，限制这些费用已成为昂贵的生物治疗费用的一个理由。作者试图回顾最新的国际文献，以估计克罗恩病目前的住院率和手术率，并将其置于历史背景中，无论它们是否随时间而变化，并比较不同司法管辖区的这些比率。正是在这种背景下，作者可以为解释一些早期数据和研究奠定基础，这些数据和研究将在更积极的生物治疗时代即将到来的住院率和手术率。来自加拿大、英国和匈牙利的最新数据都表明，在生物疗法出现之前，手术率就在下降，并且在生物疗法时代继续下降。生物疗法对手术率的影响必须在发达地区甚至在引进生物疗法之前不断减少的背景下进行分析。更积极的药物治疗是否会在很长一段时间内减少手术的需要还有待证明。
Hospitalisation and surgery are considered to be markers of more severe disease in Crohn's disease. These are costly events and limiting these costs has emerged as one rationale for the cost of expensive biologic therapies. The authors sought to review the most recent international literature to estimate current hospitalisation and surgery rates for Crohn's disease and place them in the historical context of where they have been, whether they have changed over time, and to compare these rates across different jurisdictions. It is in this context that the authors could set the stage for interpreting some of the early data and studies that will be forthcoming on rates of hospitalisation and surgery in an era of more aggressive biologic therapy. The most recent data from Canada, the United Kingdom and Hungary all suggest that surgical rates were falling prior to the advent of biologic therapy, and continue to fall during this treatment era. The impact of biologic therapy on surgical rates will have to be analysed in the context of evolving reductions in developed regions before biologic therapy was even introduced. Whether more aggressive medical therapy will decrease the requirement for surgery over long periods of time remains to be proven.