Treatment adaptations and outcomes of patients experiencing inflammatory bowel disease flares during the early COVID-19 pandemic: the PREPARE-IBD multicentre cohort study

Aamir Saifuddin; Alexandra J. Kent; Shameer J. Mehta; Lucy C. Hicks; Haidee A. Gonzalez; Jonathan P. Segal; Matthew J. Brookes; Sreedhar Subramanian; Neeraj Bhala; Thomas E. Conley; Kamal V. Patel; Christopher A. Lamb; Gareth J. Walker; Nicholas A. Kennedy; Shaji Sebastian; Shukri Abdale; Abdulla Abbesi; Anwar Abusrewil; Precious Aghimien; Saeed Ahmed; Akram Ali; Amjad Ali; Jad Alkhouri; Patrick Allen; Ammar Al-Rifaie; Richard Appleby; Ramesh Arasaradnam; Naila Arebi; Bradley Arms-Williams; Muteeb Ashraf; Au Andrea; Tamar Avades; Homira Ayubi; Samantha Baillie; Sharmili Balarajah; Aaron Bancil; Abdul Basit; Murad Bayati; Andrew Bell; Alexander Berry; Neeraj Bhala; Shivaram Bhat; Deborah Britton; Rachel Campbell; Paul Flanagan; Emma Johnston; Gary Morrison; Kirsty Nixon; Tony Tham; Bo Wang; PREPARE-IBD Collaborators; Andrew Spence

doi:10.1111/apt.17223

Treatment adaptations and outcomes of patients experiencing inflammatory bowel disease flares during the early COVID-19 pandemic: the PREPARE-IBD multicentre cohort study

Aamir Saifuddin^*, Alexandra J. Kent, Shameer J. Mehta, Lucy C. Hicks, Haidee A. Gonzalez, Jonathan P. Segal, Matthew J. Brookes, Sreedhar Subramanian, Neeraj Bhala, Thomas E. Conley, Kamal V. Patel, Christopher A. Lamb, Gareth J. Walker, Nicholas A. Kennedy, Shaji Sebastian, Shukri Abdale, Abdulla Abbesi, Anwar Abusrewil, Precious Aghimien, Saeed AhmedAkram Ali, Amjad Ali, Jad Alkhouri, Patrick Allen, Ammar Al-Rifaie, Richard Appleby, Ramesh Arasaradnam, Naila Arebi, Bradley Arms-Williams, Muteeb Ashraf, Au Andrea, Tamar Avades, Homira Ayubi, Samantha Baillie, Sharmili Balarajah, Aaron Bancil, Abdul Basit, Murad Bayati, Andrew Bell, Alexander Berry, Neeraj Bhala, Shivaram Bhat, Deborah Britton, Rachel Campbell, Paul Flanagan, Emma Johnston, Gary Morrison, Kirsty Nixon, Tony Tham, Bo Wang, PREPARE-IBD Collaborators, Andrew Spence

^*Corresponding author for this work

School of Medicine, Dentistry and Biomedical Sciences

Research output: Contribution to journal › Article › peer-review

4 Citations (Scopus)

Abstract

Background
The COVID-19 pandemic offered a unique opportunity to understand inflammatory bowel disease (IBD) management during unexpected disruption. This could help to guide practice overall.

Aims
To compare prescribing behaviour for IBD flares and outcomes during the early pandemic with pre-pandemic findings

Methods
We performed an observational cohort study comprising patients who contacted IBD teams for symptomatic flares between March and June 2020 in 60 National Health Service trusts in the United Kingdom. Data were compared with a pre-pandemic cohort after propensity-matching for age and physician global assessment of disease activity.

Results
We included 1864 patients in each of the pandemic and pre-pandemic cohorts. The principal findings were reduced systemic corticosteroid prescription during the pandemic in Crohn's disease (prednisolone: pandemic 26.5% vs. 37.1%; p
Conclusions
Despite treatment adaptations during the pandemic, steroid-free outcomes were comparable with pre-pandemic levels, although concurrent flare and suspected COVID-19 caused worse outcomes. These findings have implications for IBD management during future pandemics and for standard practice.

Original language	English
Pages (from-to)	1460-1474
Number of pages	15
Journal	Alimentary Pharmacology and Therapeutics
Volume	56
Issue number	10
Early online date	05 Oct 2022
DOIs	https://doi.org/10.1111/apt.17223
Publication status	Published - 01 Nov 2022

Bibliographical note

Funding Information:
The study was funded by Hull University Teaching Hospitals NHS Trust.

Funding Information:
We are grateful to the clinical and research teams in the participating sites for identification of patients, data collection and data entry. UK gastroenterology trainees and trainee networks (MaGNET: Mersey Gastroenterology Network, GLINT: Gastro London Investigative Network for Trainees, WMRIG: West Midlands Research in Gastroenterology, GasTRIN NoW: Gastroenterology Trainee Research and Improvement Network North-West, OxYGEN: The Oxford and Thames Valley Young Gastroenterologists Network, TReNDD NI: Trainee Research Network in Digestive Diseases Northern Ireland) were integral in data collection for this study. We appreciate support from Crohn's & Colitis UK and the British Society of Gastroenterology for promotion of this study.

Funding Information:
SS holds research grants from Biogen, Takeda, AbbVie, Tillotts Pharma, Ferring and Biohit; served on the advisory boards of Takeda, AbbVie, Merck, Ferring, Pharmacocosmos, Warner Chilcott, Janssen, Falk Pharma, Biohit, TriGenix, Celgene and Tillots Pharma; and has received speaker fees from AbbVie, Biogen, AbbVie, Janssen, Merck, Warner Chilcott and Falk Pharma. GJW has served as a speaker and/or advisory board member for AbbVie, Falk and Janssen. He has had support to attend meetings from AbbVie, Falk, Janssen and Norgine. His department has received research funding from Tillotts. NAK has served as a speaker and/or advisory board member for Allergan, Falk, Janssen, Mylan, Pharmacosmos, Takeda and Tillotts. He has had support to attend meetings from AbbVie, Falk, Janssen and Norgine. His department has received research funding from AbbVie, Celgene, Celtrion, MSD, Napp, Pfizer, Pharmacosmos and Takeda. SrS has received speaker fees from MSD, Actavis, Abbvie, Dr Falk pharmaceuticals, Shire and received educational grants from MSD, Abbvie, Actavis and is an advisory board member for Celltrion, Dr Falk pharmaceuticals and Vifor pharmaceuticals. CAL has received research support and/or has received fees for delivery of non‐promotional education from: Genentech, Janssen, Takeda, Abbvie, Dr Falk, AstraZeneca, Eli Lilly, Orion, Pfizer, Roche, Sanofi Aventis, Ferring, UCB and Biogen. MJB has received research grants from Vifor International, Pharmacosmos and Tillots Pharma; has received speaker fee from Abbvie and Vifor International; has been an advisory board member for Tillots Pharma, Vifor International; and received travel/conference expenses from Vifor International, Abbvie and Tillots Pharma. AJK has served on the advisory boards for Abbvie, Janssen and BMS Celgene and has received speaker fees from Takeda, Pfizer and Janssen; and received travel/conference expenses from Tillotts, Janssen, Abbvie and Shield Therapeutics. KP has received honoraria for educational meetings and speaker fees from Abbvie, Janssen, Takeda, DrFalk and Ferring. KP has received Advisory Board fees from Abbvie and Janssen. TEC has received speaker fees from Celltrion. LCH, HAG, SJM, AS have no conflicts of interest to declare.

Publisher Copyright:
© 2022 John Wiley & Sons Ltd.

ASJC Scopus subject areas

Hepatology
Gastroenterology
Pharmacology (medical)

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10.1111/apt.17223Licence: Unspecified

Cite this

Saifuddin, A., Kent, A. J., Mehta, S. J., Hicks, L. C., Gonzalez, H. A., Segal, J. P., Brookes, M. J., Subramanian, S., Bhala, N., Conley, T. E., Patel, K. V., Lamb, C. A., Walker, G. J., Kennedy, N. A., Sebastian, S., Abdale, S., Abbesi, A., Abusrewil, A., Aghimien, P., ... Spence, A. (2022). Treatment adaptations and outcomes of patients experiencing inflammatory bowel disease flares during the early COVID-19 pandemic: the PREPARE-IBD multicentre cohort study. Alimentary Pharmacology and Therapeutics, 56(10), 1460-1474. https://doi.org/10.1111/apt.17223

@article{d7daadfcd67745e4bde21f3c5b68ca97,

title = "Treatment adaptations and outcomes of patients experiencing inflammatory bowel disease flares during the early COVID-19 pandemic: the PREPARE-IBD multicentre cohort study",

abstract = "BackgroundThe COVID-19 pandemic offered a unique opportunity to understand inflammatory bowel disease (IBD) management during unexpected disruption. This could help to guide practice overall.AimsTo compare prescribing behaviour for IBD flares and outcomes during the early pandemic with pre-pandemic findingsMethodsWe performed an observational cohort study comprising patients who contacted IBD teams for symptomatic flares between March and June 2020 in 60 National Health Service trusts in the United Kingdom. Data were compared with a pre-pandemic cohort after propensity-matching for age and physician global assessment of disease activity.ResultsWe included 1864 patients in each of the pandemic and pre-pandemic cohorts. The principal findings were reduced systemic corticosteroid prescription during the pandemic in Crohn's disease (prednisolone: pandemic 26.5% vs. 37.1%; p ConclusionsDespite treatment adaptations during the pandemic, steroid-free outcomes were comparable with pre-pandemic levels, although concurrent flare and suspected COVID-19 caused worse outcomes. These findings have implications for IBD management during future pandemics and for standard practice.",

author = "Aamir Saifuddin and Kent, {Alexandra J.} and Mehta, {Shameer J.} and Hicks, {Lucy C.} and Gonzalez, {Haidee A.} and Segal, {Jonathan P.} and Brookes, {Matthew J.} and Sreedhar Subramanian and Neeraj Bhala and Conley, {Thomas E.} and Patel, {Kamal V.} and Lamb, {Christopher A.} and Walker, {Gareth J.} and Kennedy, {Nicholas A.} and Shaji Sebastian and Shukri Abdale and Abdulla Abbesi and Anwar Abusrewil and Precious Aghimien and Saeed Ahmed and Akram Ali and Amjad Ali and Jad Alkhouri and Patrick Allen and Ammar Al-Rifaie and Richard Appleby and Ramesh Arasaradnam and Naila Arebi and Bradley Arms-Williams and Muteeb Ashraf and Au Andrea and Tamar Avades and Homira Ayubi and Samantha Baillie and Sharmili Balarajah and Aaron Bancil and Abdul Basit and Murad Bayati and Andrew Bell and Alexander Berry and Neeraj Bhala and Shivaram Bhat and Deborah Britton and Rachel Campbell and Paul Flanagan and Emma Johnston and Gary Morrison and Kirsty Nixon and Tony Tham and Bo Wang and {PREPARE-IBD Collaborators} and Andrew Spence",

note = "Funding Information: The study was funded by Hull University Teaching Hospitals NHS Trust. Funding Information: We are grateful to the clinical and research teams in the participating sites for identification of patients, data collection and data entry. UK gastroenterology trainees and trainee networks (MaGNET: Mersey Gastroenterology Network, GLINT: Gastro London Investigative Network for Trainees, WMRIG: West Midlands Research in Gastroenterology, GasTRIN NoW: Gastroenterology Trainee Research and Improvement Network North-West, OxYGEN: The Oxford and Thames Valley Young Gastroenterologists Network, TReNDD NI: Trainee Research Network in Digestive Diseases Northern Ireland) were integral in data collection for this study. We appreciate support from Crohn's & Colitis UK and the British Society of Gastroenterology for promotion of this study. Funding Information: SS holds research grants from Biogen, Takeda, AbbVie, Tillotts Pharma, Ferring and Biohit; served on the advisory boards of Takeda, AbbVie, Merck, Ferring, Pharmacocosmos, Warner Chilcott, Janssen, Falk Pharma, Biohit, TriGenix, Celgene and Tillots Pharma; and has received speaker fees from AbbVie, Biogen, AbbVie, Janssen, Merck, Warner Chilcott and Falk Pharma. GJW has served as a speaker and/or advisory board member for AbbVie, Falk and Janssen. He has had support to attend meetings from AbbVie, Falk, Janssen and Norgine. His department has received research funding from Tillotts. NAK has served as a speaker and/or advisory board member for Allergan, Falk, Janssen, Mylan, Pharmacosmos, Takeda and Tillotts. He has had support to attend meetings from AbbVie, Falk, Janssen and Norgine. His department has received research funding from AbbVie, Celgene, Celtrion, MSD, Napp, Pfizer, Pharmacosmos and Takeda. SrS has received speaker fees from MSD, Actavis, Abbvie, Dr Falk pharmaceuticals, Shire and received educational grants from MSD, Abbvie, Actavis and is an advisory board member for Celltrion, Dr Falk pharmaceuticals and Vifor pharmaceuticals. CAL has received research support and/or has received fees for delivery of non‐promotional education from: Genentech, Janssen, Takeda, Abbvie, Dr Falk, AstraZeneca, Eli Lilly, Orion, Pfizer, Roche, Sanofi Aventis, Ferring, UCB and Biogen. MJB has received research grants from Vifor International, Pharmacosmos and Tillots Pharma; has received speaker fee from Abbvie and Vifor International; has been an advisory board member for Tillots Pharma, Vifor International; and received travel/conference expenses from Vifor International, Abbvie and Tillots Pharma. AJK has served on the advisory boards for Abbvie, Janssen and BMS Celgene and has received speaker fees from Takeda, Pfizer and Janssen; and received travel/conference expenses from Tillotts, Janssen, Abbvie and Shield Therapeutics. KP has received honoraria for educational meetings and speaker fees from Abbvie, Janssen, Takeda, DrFalk and Ferring. KP has received Advisory Board fees from Abbvie and Janssen. TEC has received speaker fees from Celltrion. LCH, HAG, SJM, AS have no conflicts of interest to declare. Publisher Copyright: {\textcopyright} 2022 John Wiley & Sons Ltd.",

year = "2022",

month = nov,

day = "1",

doi = "10.1111/apt.17223",

language = "English",

volume = "56",

pages = "1460--1474",

journal = "Alimentary Pharmacology and Therapeutics",

issn = "0269-2813",

publisher = "Wiley-Blackwell",

number = "10",

}

Saifuddin, A, Kent, AJ, Mehta, SJ, Hicks, LC, Gonzalez, HA, Segal, JP, Brookes, MJ, Subramanian, S, Bhala, N, Conley, TE, Patel, KV, Lamb, CA, Walker, GJ, Kennedy, NA, Sebastian, S, Abdale, S, Abbesi, A, Abusrewil, A, Aghimien, P, Ahmed, S, Ali, A, Ali, A, Alkhouri, J, Allen, P, Al-Rifaie, A, Appleby, R, Arasaradnam, R, Arebi, N, Arms-Williams, B, Ashraf, M, Andrea, A, Avades, T, Ayubi, H, Baillie, S, Balarajah, S, Bancil, A, Basit, A, Bayati, M, Bell, A, Berry, A, Bhala, N, Bhat, S, Britton, D, Campbell, R, Flanagan, P, Johnston, E, Morrison, G, Nixon, K, Tham, T, Wang, B, PREPARE-IBD Collaborators & Spence, A 2022, 'Treatment adaptations and outcomes of patients experiencing inflammatory bowel disease flares during the early COVID-19 pandemic: the PREPARE-IBD multicentre cohort study', Alimentary Pharmacology and Therapeutics, vol. 56, no. 10, pp. 1460-1474. https://doi.org/10.1111/apt.17223

Treatment adaptations and outcomes of patients experiencing inflammatory bowel disease flares during the early COVID-19 pandemic: the PREPARE-IBD multicentre cohort study. / Saifuddin, Aamir; Kent, Alexandra J.; Mehta, Shameer J. et al.
In: Alimentary Pharmacology and Therapeutics, Vol. 56, No. 10, 01.11.2022, p. 1460-1474.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Treatment adaptations and outcomes of patients experiencing inflammatory bowel disease flares during the early COVID-19 pandemic: the PREPARE-IBD multicentre cohort study

AU - Saifuddin, Aamir

AU - Kent, Alexandra J.

AU - Mehta, Shameer J.

AU - Hicks, Lucy C.

AU - Gonzalez, Haidee A.

AU - Segal, Jonathan P.

AU - Brookes, Matthew J.

AU - Subramanian, Sreedhar

AU - Bhala, Neeraj

AU - Conley, Thomas E.

AU - Patel, Kamal V.

AU - Lamb, Christopher A.

AU - Walker, Gareth J.

AU - Kennedy, Nicholas A.

AU - Sebastian, Shaji

AU - Abdale, Shukri

AU - Abbesi, Abdulla

AU - Abusrewil, Anwar

AU - Aghimien, Precious

AU - Ahmed, Saeed

AU - Ali, Akram

AU - Ali, Amjad

AU - Alkhouri, Jad

AU - Allen, Patrick

AU - Al-Rifaie, Ammar

AU - Appleby, Richard

AU - Arasaradnam, Ramesh

AU - Arebi, Naila

AU - Arms-Williams, Bradley

AU - Ashraf, Muteeb

AU - Andrea, Au

AU - Avades, Tamar

AU - Ayubi, Homira

AU - Baillie, Samantha

AU - Balarajah, Sharmili

AU - Bancil, Aaron

AU - Basit, Abdul

AU - Bayati, Murad

AU - Bell, Andrew

AU - Berry, Alexander

AU - Bhala, Neeraj

AU - Bhat, Shivaram

AU - Britton, Deborah

AU - Campbell, Rachel

AU - Flanagan, Paul

AU - Johnston, Emma

AU - Morrison, Gary

AU - Nixon, Kirsty

AU - Tham, Tony

AU - Wang, Bo

AU - PREPARE-IBD Collaborators

AU - Spence, Andrew

N1 - Funding Information: The study was funded by Hull University Teaching Hospitals NHS Trust. Funding Information: We are grateful to the clinical and research teams in the participating sites for identification of patients, data collection and data entry. UK gastroenterology trainees and trainee networks (MaGNET: Mersey Gastroenterology Network, GLINT: Gastro London Investigative Network for Trainees, WMRIG: West Midlands Research in Gastroenterology, GasTRIN NoW: Gastroenterology Trainee Research and Improvement Network North-West, OxYGEN: The Oxford and Thames Valley Young Gastroenterologists Network, TReNDD NI: Trainee Research Network in Digestive Diseases Northern Ireland) were integral in data collection for this study. We appreciate support from Crohn's & Colitis UK and the British Society of Gastroenterology for promotion of this study. Funding Information: SS holds research grants from Biogen, Takeda, AbbVie, Tillotts Pharma, Ferring and Biohit; served on the advisory boards of Takeda, AbbVie, Merck, Ferring, Pharmacocosmos, Warner Chilcott, Janssen, Falk Pharma, Biohit, TriGenix, Celgene and Tillots Pharma; and has received speaker fees from AbbVie, Biogen, AbbVie, Janssen, Merck, Warner Chilcott and Falk Pharma. GJW has served as a speaker and/or advisory board member for AbbVie, Falk and Janssen. He has had support to attend meetings from AbbVie, Falk, Janssen and Norgine. His department has received research funding from Tillotts. NAK has served as a speaker and/or advisory board member for Allergan, Falk, Janssen, Mylan, Pharmacosmos, Takeda and Tillotts. He has had support to attend meetings from AbbVie, Falk, Janssen and Norgine. His department has received research funding from AbbVie, Celgene, Celtrion, MSD, Napp, Pfizer, Pharmacosmos and Takeda. SrS has received speaker fees from MSD, Actavis, Abbvie, Dr Falk pharmaceuticals, Shire and received educational grants from MSD, Abbvie, Actavis and is an advisory board member for Celltrion, Dr Falk pharmaceuticals and Vifor pharmaceuticals. CAL has received research support and/or has received fees for delivery of non‐promotional education from: Genentech, Janssen, Takeda, Abbvie, Dr Falk, AstraZeneca, Eli Lilly, Orion, Pfizer, Roche, Sanofi Aventis, Ferring, UCB and Biogen. MJB has received research grants from Vifor International, Pharmacosmos and Tillots Pharma; has received speaker fee from Abbvie and Vifor International; has been an advisory board member for Tillots Pharma, Vifor International; and received travel/conference expenses from Vifor International, Abbvie and Tillots Pharma. AJK has served on the advisory boards for Abbvie, Janssen and BMS Celgene and has received speaker fees from Takeda, Pfizer and Janssen; and received travel/conference expenses from Tillotts, Janssen, Abbvie and Shield Therapeutics. KP has received honoraria for educational meetings and speaker fees from Abbvie, Janssen, Takeda, DrFalk and Ferring. KP has received Advisory Board fees from Abbvie and Janssen. TEC has received speaker fees from Celltrion. LCH, HAG, SJM, AS have no conflicts of interest to declare. Publisher Copyright: © 2022 John Wiley & Sons Ltd.

PY - 2022/11/1

Y1 - 2022/11/1

N2 - BackgroundThe COVID-19 pandemic offered a unique opportunity to understand inflammatory bowel disease (IBD) management during unexpected disruption. This could help to guide practice overall.AimsTo compare prescribing behaviour for IBD flares and outcomes during the early pandemic with pre-pandemic findingsMethodsWe performed an observational cohort study comprising patients who contacted IBD teams for symptomatic flares between March and June 2020 in 60 National Health Service trusts in the United Kingdom. Data were compared with a pre-pandemic cohort after propensity-matching for age and physician global assessment of disease activity.ResultsWe included 1864 patients in each of the pandemic and pre-pandemic cohorts. The principal findings were reduced systemic corticosteroid prescription during the pandemic in Crohn's disease (prednisolone: pandemic 26.5% vs. 37.1%; p ConclusionsDespite treatment adaptations during the pandemic, steroid-free outcomes were comparable with pre-pandemic levels, although concurrent flare and suspected COVID-19 caused worse outcomes. These findings have implications for IBD management during future pandemics and for standard practice.

AB - BackgroundThe COVID-19 pandemic offered a unique opportunity to understand inflammatory bowel disease (IBD) management during unexpected disruption. This could help to guide practice overall.AimsTo compare prescribing behaviour for IBD flares and outcomes during the early pandemic with pre-pandemic findingsMethodsWe performed an observational cohort study comprising patients who contacted IBD teams for symptomatic flares between March and June 2020 in 60 National Health Service trusts in the United Kingdom. Data were compared with a pre-pandemic cohort after propensity-matching for age and physician global assessment of disease activity.ResultsWe included 1864 patients in each of the pandemic and pre-pandemic cohorts. The principal findings were reduced systemic corticosteroid prescription during the pandemic in Crohn's disease (prednisolone: pandemic 26.5% vs. 37.1%; p ConclusionsDespite treatment adaptations during the pandemic, steroid-free outcomes were comparable with pre-pandemic levels, although concurrent flare and suspected COVID-19 caused worse outcomes. These findings have implications for IBD management during future pandemics and for standard practice.

U2 - 10.1111/apt.17223

DO - 10.1111/apt.17223

M3 - Article

AN - SCOPUS:85139236572

SN - 0269-2813

VL - 56

SP - 1460

EP - 1474

JO - Alimentary Pharmacology and Therapeutics

JF - Alimentary Pharmacology and Therapeutics

IS - 10

ER -

Treatment adaptations and outcomes of patients experiencing inflammatory bowel disease flares during the early COVID-19 pandemic: the PREPARE-IBD multicentre cohort study

Abstract

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