Impact of concomitant prescriptions and lifestyle factors on the initial course of newly diagnosed inflammatory bowel disease

Abstract

Introduction: There is a close relationship between the relapse of inflammatory bowel disease (IBD) and lifestyle factors, including concomitant medications such as non-steroidal anti-inflammatory drugs (NSAIDs), antithrombotic drugs, smoking status, and alcohol consumption. However, solid evidence is limited regarding the risk factors at diagnosis and initial disease course. This study aimed to explore the impact of concomitant prescriptions and lifestyle factors in patients with newly diagnosed IBD using a large-scale real-world database. Methods: This is a retrospective inception cohort study using the insurance claims database. Newly diagnosed patients with UC and CD were enrolled between January 2005 and May 2020. Concomitant prescriptions and lifestyle factors were assessed for new biologics use, surgery, and hospitalization during the first year. Results: In total, 6,743 patients with UC and 1,000 patients with CD were enrolled. Proton pump inhibitors, antithrombotics, antibiotics, and NSAIDs were identified as associated factors for both biologics use and hospitalization in UC patients (all p<0.01), and antithrombotics were identified as associated factors for both biologics use and hospitalization in CD patients (all p<0.01) in multivariable analyses. Interestingly, smoking was protective against hospitalization in UC patients (p<0.01), but not in CD patients (p=0.997), analyzed by univariate analysis. Alcohol consumption was protective against hospitalization outcomes in UC patients (p=0.02) but not in CD patients (p=0.27), analyzed by univariate analysis. Conclusion: Immediate attention should be paid to concomitant medications at diagnosis, because they may have impact on the initial course of IBD.