Treatment adaptations and outcomes of patients experiencing inflammatory bowel disease flares during the early COVID‐19 pandemic: the PREPARE‐IBD multicentre cohort study. Issue 10 (5th October 2022)

• Record Type: Journal Article
• Authors: Saifuddin, Aamir; Kent, Alexandra J.; Mehta, Shameer J.; Hicks, Lucy C.; Gonzalez, Haidee A.; Segal, Jonathan P.; Brookes, Matthew J.; Subramanian, Sreedhar; Bhala, Neeraj; Conley, Thomas E.; Patel, Kamal V.; Lamb, Christopher A.; Walker, Gareth J.; Kennedy, Nicholas A.; Sebastian, Shaji
• Other Names: Abdale Shukri investigator.; Abbesi Abdulla investigator.; Abusrewil Anwar investigator.; Aghimien Precious investigator.; Ahmed Saeed investigator.; Ali Akram investigator.; Ali Amjad investigator.; Alkhouri Jad investigator.; Allen Patrick investigator.; Al‐Rifaie Ammar investigator.; Appleby Richard investigator.; Arasaradnam Ramesh investigator.; Arebi Naila investigator.; Arms‐Williams Bradley investigator.; Ashraf Muteeb investigator.; Andrea Au investigator.; Avades Tamar investigator.; Ayubi Homira investigator.; Baillie Samantha investigator.; Balarajah Sharmili investigator.; Bancil Aaron investigator.; Basit Abdul investigator.; Bayati Murad investigator.; Bell Andrew investigator.; Berry Alexander investigator.; Bhala Neeraj investigator.; Bhat Shivaram investigator.; Bhattacharyya Joya investigator.; Bishop Sophia investigator.; Blackmore Laura investigator.; Bond Ashley investigator.; Borg‐Bartolo Simon investigator.; Botwright Emma investigator.; Bouri Sonia investigator.; 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Rimmer Peter investigator.; Ritchie Susan investigator.; Rosiou Konstantina investigator.; Rowland Siobhan investigator.; Sabine Joseph investigator.; Saifuddin Aamir investigator.; Sarwar Shahzad investigator.; Sasegbon Ayodele investigator.; Saunders Jayne investigator.; Sebastian Shaji investigator.; Sebepos‐Rogers Gregory investigator.; Seenan John Paul investigator.; Segal Jonathan investigator.; Selinger Christian investigator.; Serna Solange investigator.; Sethi Sonika investigator.; Shale Matthew investigator.; Shenderey Richard investigator.; Shenoy Achuth investigator.; Sherifat Yousuf investigator.; Sheth Roosy investigator.; Siakavellas Spyros investigator.; Sikafi Rafid investigator.; Singh Amar investigator.; Singh Salil investigator.; Singh Updesh investigator.; Sivaji Ganesh investigator.; Smith Philip investigator.; Speight Ally investigator.; Spence Andy investigator.; Stansfield Cath investigator.; Steed Helen investigator.; Subramanian Sreedhar investigator.; Suseehran Kishaani investigator.; Tabuso Maria investigator.; Taucius Donatas investigator.; Taylor Joanne investigator.; Thakor Amit investigator.; Tham Tony investigator.; Townsend Gill investigator.; Townsend Tristan investigator.; Troth Thomas investigator.; Tunney Ruth investigator.; Turner Kelly investigator.; Umar Nosheen investigator.; Vakeeswarasarma Vithushan investigator.; Verma Ajay investigator.; Walker Gareth investigator.; Wallace Hazel investigator.; Walton Hannah investigator.; Wang Bo investigator.; Warner Eleanor investigator.; Watson Callum investigator.; Wen Susie investigator.; Widlak Monika investigator.; Williams Maureen investigator.; Woods Amy investigator.; Younge Lisa investigator.; Zafar Mansoor investigator.;
• Is Part Of: Alimentary pharmacology & therapeutics. Volume 56:Issue 10(2022)
• Page Start: 1460
• Page End: 1474
• Publication Date: 2022-10-05
• Subjects: Digestive organs -- Diseases -- Treatment -- Periodicals; Digestive organs -- Effect of drugs on -- Periodicals; Gastrointestinal system -- Diseases -- Treatment -- Periodicals; Gastrointestinal system -- Effect of drugs on -- Periodicals; 615.73
• DOI: 10.1111/apt.17223
• Languages: English
• ISSNs: 0269-2813

Abstract

Summary: Background: The COVID‐19 pandemic offered a unique opportunity to understand inflammatory bowel disease (IBD) management during unexpected disruption. This could help to guide practice overall. Aims: To compare prescribing behaviour for IBD flares and outcomes during the early pandemic with pre‐pandemic findings Methods: We performed an observational cohort study comprising patients who contacted IBD teams for symptomatic flares between March and June 2020 in 60 National Health Service trusts in the United Kingdom. Data were compared with a pre‐pandemic cohort after propensity‐matching for age and physician global assessment of disease activity. Results: We included 1864 patients in each of the pandemic and pre‐pandemic cohorts. The principal findings were reduced systemic corticosteroid prescription during the pandemic in Crohn's disease (prednisolone: pandemic 26.5% vs. 37.1%; p < 0.001) and ulcerative colitis (UC) (prednisolone: pandemic 33.5% vs. 40.7%, p < 0.001), with increases in poorly bioavailable oral corticosteroids in Crohn's (pandemic 15.6% vs. 6.8%; p < 0.001) and UC (pandemic 11.8% vs. 5.2%; p < 0.001). Ustekinumab (Crohn's and UC) and vedolizumab (UC) treatment also significantly increased. Three‐month steroid‐free remission in each period was similar in Crohn's (pandemic 28.4% vs. 32.1%; p = 0.17) and UC (pandemic 36.4% vs. 40.2%; p = 0.095). Patients experiencing a flare and suspected COVID‐19 were more likely to have moderately‐to‐severely active disease at 3 months than those with a flare alone. Conclusions: Despite treatment adaptations during the pandemic, steroid‐free outcomes were comparable with pre‐pandemic levels, although concurrent flare and suspected COVID‐19 caused worse outcomes. These findings have implications for IBD management during future pandemics and for standard practice. Abstract : PREPARE‐IBD—treatment adaptations to treat IBD flares during the COVID‐19 pandemic compared to an age‐ and disease activity‐matched pre‐pandemic cohort.