title: Inflammatory bowel disease in the United States from 1998 to 2005: has infliximab affected surgical rates?
abstract: The treatment costs for patients in the United States with inflammatory bowel disease (IBD) exceed 1.7 billion dollars/year. Infliximab, an antibody to tumor necrosis factor-alpha has been extensively used to treat IBD, with 390,000 IBD patients receiving the drug since its FDA approval in 1998. We sought to determine the impact of infliximab on population-based rates of hospitalizations and surgical care for patients with IBD in the United States. We used data from the Nationwide Inpatient Sample to analyze patterns of hospital-based treatment provided to patients with IBD between 1998 and 2005. Data from this analysis were combined with census data to calculate trends in population-based rates of treatment. Overall rates of hospitalization for patients with Crohn's disease and ulcerative colitis increased significantly between 1998 and 2005 (5.1%/year and 3.4%/year respectively, P < 0.001 for each). During the same time period there were no changes in the overall rates of surgical care. The expanding use of infliximab has not significantly impacted the use of surgical procedures for patients with either ulcerative colitis or Crohn's disease, and rates of nonsurgical hospitalizations have actually increased. Even in the era of infliximab, surgical care remains a mainstay in the treatment of IBD.
authors.affiliation: Department of Colorectal Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA. rcannom@surgery.usc.edu
authors.forename: Rebecca R
authors.initials: RR
authors.lastname: Cannom
authors.forename: Andreas M
authors.initials: AM
authors.lastname: Kaiser
authors.forename: Glenn T
authors.initials: GT
authors.lastname: Ault
authors.forename: Robert W
authors.initials: RW
authors.lastname: Beart
authors.forename: David A
authors.initials: DA
authors.lastname: Etzioni
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003082:Colectomy / Q000706:statistics & numerical data; D039021:Colonic Pouches / Q000706:statistics & numerical data; D004766:Enterostomy / Q000706:statistics & numerical data; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery*; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D000069285:Infliximab