title: Hospitalization and surgical rates in patients with Crohn's disease treated with infliximab: a matched analysis.
abstract: OBJECTIVE
  The majority of subjects with Crohn's Disease (CD) will be hospitalized and will receive surgery for their disease. These interventions account for most of the direct costs of the disease. We sought to explore the association between infliximab use and CD-related surgery and hospitalizations.
  
  
  METHODS
  We obtained patient-level health claims between 1996 and 2007 from the Régie de l'Assurance Maladie du Québec (RAMQ), a Canadian provincial health care insurer. Subjects who were i) enrolled in the RAMQ for at least 2 years, ii) received prescription drug benefits for each year of enrolment and iii) were identified as having CD using a validated algorithm were eligible for the study. For each subject treated with infliximab, up to two closely matched comparison subjects were selected using propensity score methods. We compared time to first CD-related intra-abdominal surgery or hospitalization in infliximab users and non-users.
  
  
  RESULTS
  We matched 338 infliximab users (mean age 34, 45% male) to at least one comparison subject using propensity score matching. Subjects who received infliximab had a significantly lower risk of experiencing a CD-related intra-abdominal surgery (hazard ratio [HR] = 0.64; 95% confidence interval [CI] 0.51-0.81) or hospitalization (HR = 0.73; 95% CI 0.63-0.85). Infliximab users also experienced lower rates of hospitalized days (Rate Ratio = 0.69; 95% CI 0.49-0.97).
  
  
  CONCLUSIONS
  Our results support the real world effectiveness of infliximab therapy in reducing CD-related surgeries and hospitalizations.
authors.affiliation: Department of Pharmaceutical Sciences, University of Toronto, Toronto, ON, Canada. john.leombruno@utoronto.ca
authors.forename: John Paul
authors.initials: JP
authors.lastname: Leombruno
authors.forename: Geoffrey C
authors.initials: GC
authors.lastname: Nguyen
authors.forename: Paul
authors.initials: P
authors.lastname: Grootendorst
authors.forename: David
authors.initials: D
authors.lastname: Juurlink
authors.forename: Tom
authors.initials: T
authors.lastname: Einarson
mesh_terms: D000328:Adult; D000465:Algorithms; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D003424:Crohn Disease / Q000188:drug therapy* / Q000601:surgery; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D011792:Quebec
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D000069285:Infliximab