Hispanic patients with IBD at increased risk for hospitalization, surgery
Click Here to Manage Email Alerts
Hispanic patients treated with biologic agents for inflammatory bowel diseases face a greater risk for hospitalization, surgery and infections compared with non-Hispanic patients, according to a study in Clinical Gastroenterology and Hepatology.
“Hispanic patients have been underrepresented in clinical trials of biologic agents in IBD, and hence, there is limited data on effectiveness and safety of these agents in Hispanics,” Nghia H. Nguyen, MD, a GI fellow in medicine at UC San Diego Health, and colleagues wrote. “In our real-world study of new users of biologic agents, we observed that Hispanic patients have higher risk of hospitalization and IBD-related surgery after starting biologic agents, along with a trend towards higher risk of serious infections.”
Researchers identified 4,195 adult IBD patients using electronic health records from five academic health care centers in California. Patients were new users of biologic agents, including tumor necrosis factor-alpha antagonists, vedolizumab and ustekinumab, with consistent use for 1 year.
Nguyen and colleagues evaluated the association between ethnicity and risk for all-cause hospitalization, IBD-related surgery and serious infection using 1:4 propensity score matching and Cox proportional hazard analysis, adjusting for differences in baseline covariates and factors related to demographics, disease and treatment.
Researchers compared 240 Hispanic patients (53% men, 45% with ulcerative colitis) and 960 non-Hispanic patients (51% men, 44% with UC). Within 1 year of the start of biologic treatment, Hispanic patients had higher rates of hospitalization (30.8% vs. 22.8%), IBD-related surgery (7.1% vs. 4.6%) and serious infection (8.8% vs. 4.9%) compared with non-Hispanic patients, per propensity score matching.
Cox proportional hazard analysis further revealed that Hispanic patients were 71% more likely to have IBD-related surgery than non-Hispanic patients. There was no significant risk increase for major infections after adjusting for demographics, disease and treatment; however, factors such as low albumin at baseline, prior serious infection and concomitant use of opiates were linked to an increased risk for infections in Hispanic patients.
Study limitations include a lack of detailed data on significant confounders that could impact treatment choice and outcomes, such as disease duration, patient-reported outcomes and endoscopy reports. The researchers also wrote that dispensing and use of medications could not confirmed.
“Understanding the impact of ethnicity on treatment outcomes and health care utilization is critical for improving IBD management in Hispanic patients,” the authors wrote.
Collapse
Read more about
Click Here to Manage Email Alerts