Sex-Based Disparities in Treatment and Healthcare Utilization in Patients with Ulcerative Colitis: A Systematic...

Area of Science:

• Gastroenterology and Hepatology
• Clinical Medicine
• Health Services Research

Background:

• Sex-related treatment disparities are prevalent in medicine but underexplored in inflammatory bowel disease (IBD).
• Ulcerative colitis (UC) management may exhibit sex-based differences in medical and surgical approaches.
• Understanding these differences is crucial for optimizing healthcare utilization in UC patients.

Purpose of the Study:

• To investigate sex-based differences in the medical and surgical management of ulcerative colitis (UC).
• To examine correlations between biological sex and variations in healthcare utilization for UC.
• To identify potential sex-specific disparities in UC treatment and outcomes.

Main Methods:

• Systematic literature search across MEDLINE, Google Scholar, Cochrane Library, and ScienceDirect up to April 2024.
• Meta-analysis of eight observational studies involving 47,089 patients (51.9% females) using RevMan 5.4.
• Random-effects model applied to combine odds ratios for primary and secondary outcomes; study registered with PROSPERO.

Main Results:

• No significant sex differences observed in biologic therapy (OR 0.89) or corticosteroid use (OR 1.17).
• Females were significantly less likely to use immunomodulators compared to males (OR 0.89, p < 0.0001).
• No significant differences in surgical interventions; females experienced higher annual UC-related hospitalizations (OR 1.41, p < 0.00001).

Conclusions:

• While biologic and surgical treatments for UC showed no sex differences, disparities exist in immunomodulator use.
• Higher hospitalization rates in females highlight potential sex-specific challenges in UC management.
• The findings underscore the necessity for developing and implementing sex-specific strategies for ulcerative colitis care.