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. 2019 Oct 18;25(11):1773-1779.
doi: 10.1093/ibd/izz056.

Prevalence of Fistulizing Crohn's Disease in the United States: Estimate From a Systematic Literature Review Attempt and Population-Based Database Analysis

David A Schwartz  1 , Ignacio Tagarro  2 , Mary Carmen Díez  3 , William J Sandborn  4
Affiliations

Prevalence of Fistulizing Crohn's Disease in the United States: Estimate From a Systematic Literature Review Attempt and Population-Based Database Analysis

David A Schwartz et al. Inflamm Bowel Dis. .

Erratum in

Abstract

Background: Fistulas may arise as a relevant complication of Crohn's disease (CD). Despite their clinical significance and the substantial burden imposed on patients, limited data are available on the epidemiology of fistulizing CD in the United States.

Methods: A systematic literature review was conducted to identify data published between 1970 and 2017 on the epidemiology of fistulas in patients with CD, with the aim to estimate the number of prevalent cases in the United States. Retrieved titles and abstracts were screened by 2 independent researchers for inclusion criteria (US population-based studies reporting data on the epidemiology of fistulizing CD). To validate the literature-based estimate, data from a US claims database (Truven Health MarketScan database) were analyzed. This database has broad geographic coverage, with health care data for >60 million patients during the period of the analysis.

Results: The literature search retrieved 7 articles for full-text review, and only 1 met the criteria for inclusion. This study described the cumulative incidence of fistulas in a CD population from Minnesota over 20 years. From the reported data, the estimated number of prevalent cases with fistulizing CD in the United States was ~76,600 in 2017 (~52,900 anal, ~7400 rectovaginal, ~2300 enterocutaneous, and ~14,100 internal). Analysis from the US health care database resulted in an estimated number of ~75,700 patients, confirming the robustness of the original estimate from the literature.

Conclusions: Based on 2 separate analyses, the estimated number of patients with fistulizing CD in the United States is ~77,000 patients.

Keywords: Crohn’s disease/CD; epidemiology; fistula; prevalence.

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Figures

FIGURE 1.
FIGURE 1.
Literature review flow diagram (Preferred Reporting Items for Systematic Reviews and Meta-Analyses).
See this image and copyright information in PMC

References

    1. Siegmund B, Feakins RM, Barmias G, et al. . Results of the Fifth Scientific Workshop of the ECCO (II): pathophysiology of perianal fistulizing disease. J Crohns Colitis. 2016;10:377–386. - PMC - PubMed
    1. Schwartz DA, Loftus EV Jr, Tremaine WJ, et al. . The natural history of fistulizing Crohn’s disease in Olmsted County, Minnesota. Gastroenterology. 2002;122:875–880. - PubMed
    1. Mahadev S, Young JM, Selby W, et al. . Quality of life in perianal Crohn’s disease: what do patients consider important? Dis Colon Rectum. 2011;54:579–585. - PubMed
    1. Scharl M, Rogler G. Pathophysiology of fistula formation in Crohn’s disease. World J Gastrointest Pathophysiol. 2014;5:205–212. - PMC - PubMed
    1. Nielsen OH, Rogler G, Hahnloser D, et al. . Diagnosis and management of fistulizing Crohn’s disease. Nat Clin Pract Gastroenterol Hepatol. 2009;6:92–106. - PubMed

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