P468. Hospitalization rate before and after anti-TNF therapy, results from two referral centers
P.A. Golovics1, A. Balint2, M. Mandel1, Z. Vegh1, A. Mohas1, B. Szilagyi1, A. Szabo1, Z. Kurti1, L. Kiss1, B. Lovasz1, K. Farkas2, T. Molnar2, P. Lakatos1, 1Semmelweis University, 1st Department of Medicine, Budapest, Hungary, 2University of Szeged, 1st Department of Medicine, Szeged, Hungary
Hospitalization is an important outcome measure and a major driver of costs in patients with IBD. Our aim was to analyze prospectively the prevalence and predictors of hospitalization and re-hospitalization before and after anti-TNF therapy.
Data of 194 consecutive IBD (152 CD, 42 UC) patients were analyzed (male/female: 88/106, median age at diagnosis: 24.0, IQR: 19–30 years, duration: 8, IQR: 8–12.5 years) in whom anti-TNF therapy was started after January 1, 2009. Total follow-up was 1874 patient-years and 474 patient-years with anti-TNF exposure. Both in- and outpatient records were collected and comprehensively reviewed.
The hospitalization rate in the 2 years preceding anti-TNF therapy was significantly higher compared to the hospitalization rate during anti-TNF therapy (61.6/100 patient-years vs. 43.2/100 anti-TNF exposed patient-years, OR: 0.64, 95% CI 0.43–0.95, p = 0.03) in the total cohort. The risk for hospitalization decreased only in CD (OR: 0.57, 95% CI 0.36–0.90, p = 0.02), but not UC and in univariate analysis it was associated with female gender (p = 0.02), previous surgery (p = 0.03) and smoking (p = 0.03). The same tendency was observed for complicated behavior (p = 0.06) and lack of perianal disease (p = 0.08).
Hospitalization rates decreased significantly in this referral CD but not UC cohort after the introduction of anti-TNF therapy. The decrease in hospitalization rates after the introduction of anti-TNF therapy was associated to gender, previous surgery and smoking habits.