Background
Methods
Study population
Statistical analysis
Results
Study population and medication
Characteristics | Crohn’s disease | Ulcerative Colitis | ||||||
---|---|---|---|---|---|---|---|---|
All, n (%) | Biologics users, n (%) | Non-biologics users, n (%) | P-value | All, n (%) | Biologics users, n (%) | Non-biologics users, n (%) | P-value | |
Patients | 235 (23) | 113 (48) | 122 (52) | 800 (77) | 63 (8) | 737 (92) | ||
Age (mean ± SD) | 42.27 ± 9.95 | 40.82 ± 9.09 | 44.00 ± 10.49 | 0.014 | 46.19 ± 10.83 | 45.25 ± 11.83 | 46.27 ± 10.74 | 0.474 |
≤ 40 years | 102 (43) | 55 (49) | 47 (39) | 251 (31) | 24 (38) | 227 (31) | ||
41–65 years | 124 (53) | 55 (49) | 69 (57) | 466 (58) | 34 (54) | 432 (59) | ||
> 65 years | 9 (4) | 3 (2) | 6 (4) | 83 (11) | 5 (8) | 78 (10) | ||
Gender | 0.521 | 0.285 | ||||||
Male | 168 (71) | 83 (73) | 85 (70) | 507 (63) | 36 (57) | 471 (64) | ||
Female | 67 (29) | 30 (27) | 37 (30) | 293 (37) | 27 (43) | 266 (36) | ||
Marriage status | 0.253 | 0.335 | ||||||
Married | 124 (53) | 64 (57) | 60 (49) | 261 (33) | 24 (38) | 237 (32) | ||
Single | 111 (47) | 49 (43) | 62 (51) | 539 (77) | 39 (62) | 500 (68) | ||
Highest Education | 0.010 | 0.973 | ||||||
College or less | 136 (58) | 73 (65) | 63 (52) | 383 (48) | 31 (49) | 352 (48) | ||
Bachelor’s degree | 84 (36) | 38 (34) | 46 (38) | 363 (45) | 28 (44) | 335 (45) | ||
Master’s degree | 15 (6) | 2 (1) | 13 (10) | 54 (7) | 4 (6) | 50 (7) | ||
Occupation | 0.645 | 0.986 | ||||||
Fulltime | 130 (55) | 64 (57) | 66 (54) | 450 (56) | 34 (54) | 416 (56) | ||
Part-time | 19 (8) | 8 (7) | 11 (9) | 76 (10) | 7 (11) | 69 (9) | ||
Self employed | 20 (9) | 7 (6) | 13 (11) | 59 (7) | 6 (10) | 53 (7) | ||
House wife/house keeper | 24 (10) | 11 (10) | 13 (11) | 103 (13) | 8 (13) | 95 (13) | ||
Student | 2 (1) | 2 (2) | 0 (0) | 2 (0) | 0 (0) | 3 (0) | ||
Unemployed/Pensioner | 38 (16) | 20 (18) | 18 (15) | 94 (12) | 7 (11) | 87 (12) | ||
Others | 2 (1) | 1 (0) | 1 (0) | 15 (2) | 1 (1) | 14 (3) | ||
Household incomes | 0.967 | 0.427 | ||||||
< 2 M JPY | 23 (10) | 11 (10) | 12 (10) | 72 (9) | 4 (6) | 68 (9) | ||
2–4 M JPY | 47 (20) | 21 (19) | 26 (21) | 144 (18) | 13 (21) | 131 (18) | ||
4–6 M JPY | 55 (24) | 25 (22) | 30 (25) | 185 (23) | 16 (26) | 169 (23) | ||
6–8 M JPY | 36 (15) | 20 (18) | 16 (13) | 135 (17) | 9 (14) | 126 (17) | ||
8–10 M JPY | 24 (10) | 11 (10) | 13 (11) | 75 (9) | 2 (3) | 73 (10) | ||
> 10 M JPY | 19 (8) | 9 (8) | 10 (8) | 85 (11) | 7 (11) | 78 (11) | ||
Not revealed | 31 (13) | 16 (13) | 15 (12) | 104 (13) | 12 (19) | 92 (12) | ||
Comorbidity | ||||||||
Dyslipidemia | 34 (14) | 9 (8) | 25 (20) | 0.006 | 83 (10) | 10 (16) | 73 (10) | 0.136 |
Hypertension | 38 (16) | 10 (9) | 28 (23) | 0.003 | 108 (14) | 15 (24) | 93 (13) | 0.013 |
COPD Asthma | 13 (6) | 5 (4) | 8 (7) | 0.475 | 28 (4) | 9 (14) | 19 (3) | < 0.001 |
Diabetes | 16 (7) | 5 (4) | 11 (9) | 0.163 | 56 (7) | 13 (21) | 43 (6) | < 0.001 |
Depression | 17 (7) | 5 (4) | 12 (10) | 0.110 | 48 (6) | 4 (6) | 44 (6) | 0.903 |
OA and RA | 12 (5) | 4 (4) | 8 (7) | 0.294 | 32 (4) | 9 (14) | 23 (3) | < 0.001 |
Gastrointestinal disease | 15 (6) | 5 (4) | 10 (8) | 0.237 | 49 (6) | 11 (18) | 38 (5) | < 0.001 |
Current treatment | ||||||||
Nutritional | 137 (58) | 65 (58) | 72 (59) | 0.816 | 107 (13) | 18 (28) | 89 (12) | < 0.001 |
5-ASA | 168 (71) | 82 (73) | 86 (70) | 0.725 | 656 (82) | 56 (89) | 600 (81) | 0.138 |
Steroid | 39 (17) | 16 (14) | 23 (19) | 0.334 | 127 (16) | 21 (33) | 106 (14) | < 0.001 |
immunomodulator | 53 (23) | 30 (27) | 23 (19) | 0.158 | 61 (8) | 27 (43) | 64 (9) | < 0.001 |
Biologic agents | 112 (48) | – | – | 56 (7) | – | – | ||
Cytapheresis | 1 (0) | 0 (0) | 1 (1) | 0.335 | 16 (2) | 7 (11) | 9 (1) | < 0.001 |
Surgical history | ||||||||
Yes | 146 (62) | 72 (64) | 74 (61) | 0.629 | 94 (12) | 13 (21) | 81 (11) | 0.023 |
Time since diagnosis | 0.179 | 0.267 | ||||||
0–2 years | 27 (11) | 8 (7) | 19 (16) | 134 (17) | 7 (11) | 127 (17) | ||
3–8 years | 66 (28) | 34 (30) | 31 (25) | 296 (37) | 30 (48) | 266 (36) | ||
9–15 years | 44 (19) | 24 (21) | 20 (16) | 197 (25) | 15 (24) | 182 (25) | ||
> 15 years | 99 (42) | 47 (42) | 52 (43) | 173 (22) | 11 (17) | 162 (22) | ||
Type of hospitals | 0.657 | 0.001 | ||||||
University hospital | 92 (39) | 41 (36) | 51 (42) | 160 (20) | 25 (40) | 135 (18) | ||
General/Specialist hospital | 128 (55) | 65 (57) | 63 (52) | 410 (51) | 26 (41) | 384 (52) | ||
Clinics | 15 (6) | 7 (7) | 8 (6) | 229 (29) | 12 (19) | 217 (30) | ||
Others | 0 (0) | 0 (0) | 0 (0) | 1 (0) | 0 (0) | 1 (0) | ||
Frequency of visit | < 0.001 | < 0.001 | ||||||
More than once a month | 38 (16) | 11 (10) | 27 (22) | 61 (8) | 16 (24) | 46 (6) | ||
Once every month | 73 (31) | 29 (26) | 44 (36) | 281 (35) | 27 (43) | 254 (35) | ||
Once every 2 months | 94 (40) | 69 (61) | 25 (20) | 247 (31) | 20 (32) | 227 (31) | ||
Less than every 2 months | 30 (13) | 4 (3) | 26 (22) | 211 (26) | 1 (1) | 210 (28) |
Determinants of biologic treatment
Characteristics | Overall, ORs, (95%CI) | Crohn’s disease, ORs (95%CI) | Ulcer Colitis, ORs (95%CI) |
---|---|---|---|
Age (reference ≤40 years) | |||
41–65 years |
0.59 (0.37–0.93)
|
0.41 (0.17–0.95)
| 0.86 (0.42–1.74) |
> 65 years |
0.24 (0.09–0.65)
| 0.37 (0.05–2.85) | 0.31 (0.08–1.26) |
Gender (reference male) | |||
Female | 0.77 (0.46–1.29) |
0.30 (0.11–0.79)
| 1.67 (0.77–3.63) |
Marriage status (reference married) | |||
Single | 0.68 (0.41–1.10) | 0.87 (0.37–2.04) | 1.29 (0.60–2.81) |
Highest Education (reference college or less) | |||
Bachelor’s degree | 0.76 (0.49–1.18) | 0.51 (0.22–1.19) | 1.01 (0.51–2.02) |
Master’s degree and higher |
0.26 (0.10–0.71)
|
0.06 (0.01–0.41)
| 1.45 (0.41–5.16) |
Occupation | |||
Fulltime | 2.74 (0.43–7.13) | 0.38 (0.01–1.17) | 2.38 (0.25–3.00) |
Part-time | 2.16 (0.32–4.70) | 0.28 (0.01–1.07) | 1.57 (0.14–17.08) |
Self employed | 2.39 (0.34–6.52) | 0.21 (0.01–7.28) | 3.21 (0.28–6.28) |
House wife | 3.24 (0.46–2.52) | 0.25 (0.01–1.69) | 1.95 (0.17–2.24) |
Student | 5.20 (0.30–9.37) | 0 (Omitted) | 0 (Omitted) |
Unemployed/Pensioner | 3.50 (0.54–2.65) | 0.77 (0.02–5.11) | 2.44 (0.22–6.58) |
Household incomes (reference less than 2 M JPY) | |||
2–4 M JPY | 1.26 (0.55–2.87) | 0.25 (0.06–1.03) | 1.49 (0.40–5.59) |
4–6 M JPY | 1.56 (0.69–3.56) | 1.04 (0.28–3.86) | 1.16 (0.29–4.56) |
6–8 M JPY | 1.50 (0.62–3.61) | 1.98 (0.45–8.83) | 0.74 (0.17–3.22) |
8–10 M JPY | 1.43 (0.51–4.01) | 0.84 (0.17–4.27) | 0.57 (0.08–4.09) |
> 10 M JPY | 1.24 (0.45–3.41) | 1.05 (0.18–6.02) | 0.51 (0.09–2.71) |
Comorbidity | |||
Dyslipidemia | 0.55 (0.23–1.34) | 0.73 (0.13–3.96) | 0.36 (0.09–1.56) |
Hypertension | 0.85 (0.42–1.72) | 0.41 (0.11–1.60) | 1.20 (0.44–3.28) |
COPD Asthma | 1.70 (0.62–4.61) | 3.32 (0.39–8.54) | 2.00 (0.53–7.57) |
Diabetes | 1.42 (0.60–3.33) | 0.97 (0.15–6.34) | 2.48 (0.80–7.64) |
Depression | 0.64 (0.27–1.49) | 0.49 (0.10–2.30) | 0.61 (0.16–2.36) |
OA and RA | 1.27 (0.29–5.52) | 0.41 (0.04–4.45) | 2.44 (0.24–24.85) |
Gastrointestinal disease | 1.03 (0.41–2.57) | 0.69 (0.10–4.55) | 1.39 (0.39–4.93) |
Surgical history | |||
Previous surgical history |
1.98 (1.24–3.16)
| 1.15 (0.53–2.47) | 0.82 (0.28–2.36) |
Current treatment | |||
Nutritional |
3.16 (2.00–5.12)
| 1.90 (0.87–4.12) | 2.42 (1.00–5.89) |
5-ASA | 0.89 (0.54–1.49) | 1.05 (0.46–2.39) | 1.24 (0.46–3.35) |
Steroid | 1.04 (0.61–1.78) | 2.25 (0.81–6.26) | 1.19 (0.56–2.56) |
Immunosuppressant |
3.15 (1.94–5.12)
| 1.44 (0.62–3.28) |
4.61 (2.25–9.45)
|
Cytapheresis | 1.23 (0.33–4.64) | 0 (Omitted) | 2.00 (0.41–9.68) |
Time since diagnosis (reference 0–2 years) | |||
3–8 years |
3.63 (1.69–7.76)
| 1.48 (0.33–6.54) |
4.27 (1.33–3.72)
|
9–15 years |
3.26 (1.42–7.45)
| 1.10 (0.22–5.52) |
3.99 (1.13–4.13)
|
> 15 years |
4.16 (1.80–9.56)
| 0.92 (0.20–4.28) |
3.95 (1.04–4.90)
|
Type of hospitals (reference university hospital) | |||
General/Specialist hospital |
0.62 (0.40–0.96)
| 1.09 (0.50–2.34) |
0.41 (0.19–0.84)
|
Clinics |
0.47 (0.24–0.89)
| 0.42 (0.10–1.79) | 0.43 (0.17–1.09) |
Frequency of visit (Reference less than once in a month) | |||
Once every month | 0.91 (0.45–1.84) | 1.56 (0.47–5.22) | 0.58 (0.22–1.56) |
Once every 2 months | 1.83 (0.88–3.82) |
14.36 (3.98–51.83)
| 0.50 (0.17–1.45) |
Once every 3 months | 0.09 (0.03–0.27) | 0.26 (0.05–1.21) |
0.03 (0.01–0.29)
|
Less than every 3 months | 0 (Omitted) | 0 (Omitted) | 0 (Omitted) |