Increased Medication Utilization Precedes Incidentally Diagnosed Inflammatory Bowel Disease: A Multicenter,...

Area of Science:

• Gastroenterology
• Immunology
• Internal Medicine

Background:

• Inflammatory Bowel Disease (IBD), encompassing Crohn's disease and ulcerative colitis, is often diagnosed after symptom onset.
• Subclinical inflammation may precede overt clinical manifestations of IBD.
• Early detection of IBD can lead to timely intervention and improved patient outcomes.

Purpose of the Study:

• To investigate the association between subclinical inflammation in asymptomatic IBD patients and medication usage patterns.
• To determine if increased medication use in asymptomatic individuals can serve as an early indicator of IBD.
• To compare medication use in asymptomatic IBD patients with symptomatic IBD patients and healthy controls.

Main Methods:

• Multicenter, retrospective analysis of patients diagnosed with ulcerative colitis or Crohn's disease between 2010 and 2021.
• Inclusion criteria: incidental IBD diagnosis during colorectal cancer screening.
• Comparison of medication use (cardiovascular, antiparasitic, musculoskeletal, respiratory, sensory organ) in asymptomatic IBD patients versus symptomatic IBD patients and healthy non-IBD controls up to five years prior to diagnosis.

Main Results:

• Asymptomatic patients later diagnosed with IBD exhibited significantly higher use of various medication classes up to five years before their diagnosis.
• Medication classes with increased use included cardiovascular, antiparasitic, musculoskeletal, respiratory, and sensory organ drugs.
• This pattern suggests a prolonged period of systemic inflammation preceding clinical diagnosis.

Conclusions:

• Subclinical inflammation in IBD is associated with increased medication use years before diagnosis.
• Medication patterns may indicate a systemic inflammatory process, offering potential for earlier IBD detection.
• Further research into pre-diagnostic medication use could refine early diagnostic strategies for IBD.