![]() ![]() 23 24 For patients to be classified as having FCD, they had to have at least two distinct outpatient visits or one inpatient visit for FCD within 2 years (K50.012, K50.112, K50.812, K50.912). From this group, we identified patients as having CD if ≥80% of distinct International Statistical Classification of Diseases, Tenth Revision ( ICD-10) diagnosis codes were K50.xx. To be initially identified as having IBD, patients had to have at least two distinct outpatient visits or one inpatient visit for IBD within 2 years (K50.xx and K51.xx). We selected a cohort of patients aged ≥18 years who received an inclusive CD diagnosis (FCD and CD without fibrostenotic symptoms (non-FCD)) between 30 October 2015 and 30 September 2018. In this study, we aimed to compare the differences in health outcomes and direct healthcare costs between patients with FCD and patients with CD without clinical stricturing using a population-based data set in the USA. 22Ĭonsidering the devastating consequences of untreated stricturing in FCD, it is important to effectively describe the unmet needs in this patient population by characterising health outcomes and costs of care associated with FCD. 14 21 Signs and symptoms of clinical obstruction may include abdominal pain, constipation, nausea and vomiting, and, notably, loss of appetite or inability to tolerate foods, leading to chronic malnutrition. Scarring from the strictures can lead to intestinal narrowing, ultimately culminating in clinical obstruction. Understandably, intestinal stricture formation in FCD can be devastating to patients. 3 8 12–15 Furthermore, repeated interventional endoscopic procedures, such as balloon dilation, appear to be a temporising measure with limited long-term usefulness. 8 9 In light of this, rates of intestinal surgery and recurrence of strictures after surgery remain high and unchanged in FCD. 6 10 Although anti-inflammatory medical therapy is the standard of care, the evolution of strictures in FCD is thought to have a parallel pathogenesis that requires add-on antifibrotic treatment. Previous research indicates that >50% of patients with CD will develop intestinal strictures in their lifetimes. ![]() 5–8 Despite newer therapies now available or in development for IBD, none are approved for the treatment of fibrosis in IBD, hallmarking a critical unmet medical need for affected patients with fibrostenotic CD (FCD). 2–4 Stricturing is the result of ongoing chronic activation of myofibroblasts by inflammation in the GI lining. 1 Various phenotypes of CD have been characterised according to the Montreal classification based on age at diagnosis, gastrointestinal (GI) tract location, and behaviour of the disease course. Crohn’s disease (CD) is a type of inflammatory bowel disease (IBD) with a relapsing and remitting disease course. ![]()
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