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Related Concept Videos

Inflammatory Bowel Disease II: Crohn's Disease01:30

Inflammatory Bowel Disease II: Crohn's Disease

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Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
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Inflammatory Bowel Disease V: Surgical Management01:21

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Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
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Chronic Bowel Disorders: Introduction01:17

Chronic Bowel Disorders: Introduction

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Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
336
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

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Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
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Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

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Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
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Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids01:21

Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids

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Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
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Temporal Trends in Surgery and Hospitalization Rates for Crohn's Disease in Brazil: A Population-Based Study.

João Augusto Dos Reis Guerra1, Daniela Oliveira Magro2, Claudio Saddy Rodrigues Coy2

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Despite rising Crohn's disease (CD) diagnoses and increased biologic use in Brazil, hospitalizations and surgeries decreased. This suggests improved management of CD patients, even with a growing disease burden.

Keywords:
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Area of Science:

  • Gastroenterology
  • Public Health
  • Pharmacoeconomics

Background:

  • Biological therapies have significantly impacted inflammatory bowel disease (IBD) management.
  • Controversies persist regarding the effectiveness of biological therapies in reducing surgical rates for Crohn's disease (CD).
  • Understanding temporal trends in CD treatment and outcomes is crucial for public health policy.

Purpose of the Study:

  • To analyze temporal trends in surgery and hospitalization rates among CD patients in Brazil.
  • To correlate these trends with the dispensing patterns of key medications: azathioprine (AZA), infliximab (IFX), and adalimumab (ADA).
  • To evaluate the impact of biological therapies on CD management outcomes within the Brazilian National Healthcare System.

Main Methods:

  • A retrospective observational study utilizing data from 2012 to 2022.
  • Analysis of demographic data, medication dispensing, and International Classification of Diseases (ICD) codes for CD-related hospitalizations and surgeries.
  • Calculation of Annual Average Percent Changes (AAPCs) to assess temporal trends in disease prevalence, treatment, hospitalization, and surgical procedures.

Main Results:

  • CD diagnoses increased by 288.07% between 2012 and 2022.
  • Absolute use of AZA, IFX, and ADA increased, but the proportion of patients on AZA decreased significantly (-57.28%).
  • Despite increased CD cases and biologic availability, the proportion of hospitalizations (-59.29%) and surgeries (-55.08%) among CD patients decreased.

Conclusions:

  • The proportion of hospitalizations and surgical procedures among CD patients in Brazil has decreased.
  • This decline occurred despite a substantial increase in CD prevalence and absolute biologic dispensing.
  • Findings suggest potential improvements in CD management and treatment efficacy within the public healthcare system.