711 Comorbidity Burden Among Patients With Ulcerative Colitis in the United States

Abstract

INTRODUCTION: The symptoms and comorbidities associated with ulcerative colitis (UC) add to the disease burden. Long-term assessment of the comorbidities associated with UC is needed. The objective of this study was to evaluate UC-related comorbidities, including opioid use as a proxy for pain diagnosis, among patients in the United States. METHODS: This was a retrospective matched cohort study. Working age adults with UC (≥2 independent claims with a UC diagnosis ≥30 days apart and within 1 year; first UC diagnosis was the index date) and controls without diagnosis for inflammatory bowel disease (IBD; random index date) were identified in a US healthcare claims database (OptumHealth Care Solutions, Inc.) of privately-insured patients (01/1999-03/2017). UC patients were matched 1:5 with non-IBD controls using baseline characteristics, including the Quan-Charlson comorbidity index and cardiovascular disease. Comorbidities during the 12-month baseline period before the index date were reported. During the follow-up, the incidence of new comorbidity, including opioid use, was compared to the non-IBD matched controls by Kaplan-Meier (KM) rate with log-rank test. RESULTS: There were 9,353 UC patients and 46,765 non-IBD matched patients in the study sample. The average age was 46 years old, and 50% of patients were female. At baseline, the symptoms and comorbidities significantly higher in the UC cohort were pain, fatigue, and anemia (Figure 1). During the follow-up, the rate of new cases of cardiovascular disease was significantly higher in the UC compared to the matched non-IBD cohort, reaching 8.8% vs 7.8% at year 6, respectively (Figure 2). The rates of new cases of fatigue (4.7 vs 3.3%), anemia (4.8 vs 1.8%), respiratory disease (2.9 vs 1.8%), and anxiety (4.1 vs 2.6%) were also significantly higher in the UC cohort compared to the non-IBD cohort by year 6 (P-value < 0.001). Rates of new pain diagnosis or opioid use cases were significantly higher in the UC cohort reaching 70.8% compared to 58.0% in the non-IBD cohort, by year 6 (Figure 3). CONCLUSION: In this large retrospective study with long follow-up, comorbidities occurred more frequently in UC compared to matched non-IBD patients. Notably, the rate of new cases of pain/opioid use was significantly higher in UC patients reaching 70.8% by the end of follow-up. These results suggest that patients with UC also have a higher rate of concurrent comorbidities, which add to the disease burden.