Resumen
Objetivos
Valorar el impacto del tratamiento anti-TNF\(\upalpha\) en hospitalizaciones y cirugías por enfermedad inflamatoria intestinal (EII).
Métodos
Estudio retrospectivo que compara los ingresos hospitalarios por EII antes y tras el uso de anti-TNF\(\upalpha \), usando como marco de referencia las hospitalizaciones totales del centro y las debidas a enfermedades digestivas.
Resultados
Antes de disponer de los fármacos anti-TNF\(\upalpha \) (periodo 1994–2000) los ingresos médicos por EII supusieron el 0,55% del total de los ingresos hospitalarios y el 5,36% de los debidos a patología digestiva. Una vez disponibles los anti-TNF\(\upalpha \) (entre 2001–2010) las hospitalizaciones por EII se redujeron al 0,47% y 3,82% respectivamente, es decir, un 14,54% menos de ingresos médicos por EII respecto de los totales hospitalarios. Con relación a los debidos a patologías digestivas en su conjunto, los ingresos médicos y quirúrgicos por EII se redujeron un 28,73% y un 39,34% respectivamente. La probabilidad de que se produjeran menos ingresos médicos por EII al disponer de anti-TNF\(\upalpha \) fue del 45% (OR 1,45; IC 95%: 1,26–1,67; \(p < 0{,}001\)) y del 67% para cirugías en pacientes con EII (OR: 1,67; IC 95%: 1,10–2,54; \(p = 0{,}021\)). En nuestro centro estas cifras suponían una reducción de 15,3 ingresos médicos/año y 2,21 cirugías/año por EII.
Conclusiones
La disponibilidad de los fármacos anti-TNF\(\upalpha \) reduce significativamente los ingresos médicos y quirúrgicos en pacientes con EII.
Abstract
Aim
To valorate the impact of anti-TNF\(\upalpha\) therapy on hospitalizations and surgeries in inflammatory bowel disease (IBD).
Methods
Retrospective study comparing hospital admissions for IBD before and after the use of anti-TNF\(\upalpha\) therapy, using as a frame of reference the total hospitalizations of the center and those due to digestive diseases.
Results
Before anti-TNF\(\upalpha\) became available (years 1994 to 2000) medical IBD admissions accounted 0.55% of total hospital admissions and 5.36% of those due to digestive diseases, while from 2001 to 2010 these rates were 0.47% and 3.82% respectively. Once anti-TNF\(\upalpha\) were in use (years 2001 to 2010) hospitalizations for IBD were reduced to 0.47% and 3.82% respectively, equivalent to 14.54% fewer medical admissions for IBD with respect to total hospital admissions. In relation to those due to digestive diseases, medical and surgical admissions for IBD were reduced by 28.73% and 39.34% respectively. Likelihood of reducing medical admissions due to IBD when anti-TNF\(\upalpha\) were available was 45% (OR 1.45; 95% CI: 1.26–1.67; \(p<0.001\)) and 67% when IBD surgical admissions were considered (OR: 1.67; 95% CI: 1.10–2.54; \(p=0.021\)). In our hospital, these figures implied a reduction of 15.3 medical admissions/year and 2.21 surgeries/year due to IBD.
Conclusions
The availability of anti-TNF\(\upalpha\) drugs significantly reduced medical and surgical admissions in patients with IBD.
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Fernández-Pérez, F.J., Moreno-García, A.M., Hinojosa-Guadix, J. et al. Impacto del tratamiento biológico en la hospitalización y en el coste de la enfermedad inflamatoria intestinal. PharmacoEcon Span Res Artic 14, 93–99 (2017). https://doi.org/10.1007/s40277-018-0075-8
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DOI: https://doi.org/10.1007/s40277-018-0075-8