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Wei SC, Sollano J, Hui YT, Yu W, Santos Estrella PV, Llamado LJQ, Koram N. Epidemiology, burden of disease, and unmet needs in the treatment of ulcerative colitis in Asia. Expert Rev Gastroenterol Hepatol 2021; 15:275-289. [PMID: 33107344 DOI: 10.1080/17474124.2021.1840976] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Ulcerative colitis (UC) is an idiopathic, chronic inflammatory disease of the colon, characterized by relapsing and remitting symptoms. Although traditionally viewed as a Western disease, the incidence and prevalence of UC is increasing in developing regions, including Asian countries. AREAS COVERED A PubMed search identified articles describing epidemiology, disease burden, patient demographics, clinical characteristics, risk factors, and treatment of UC across Asia. We review the epidemiology and disease course of UC across Asia, including region-specific factors that may aid development of more cost-effective treatment approaches tailored to the needs of Asian populations. EXPERT OPINION The opinion of non-Pfizer-affiliated practicing gastroenterologists is that epidemiological data from the last four decades have shown 1.5-fold to almost 20-fold increases in the incidence and prevalence of UC in some Asian countries, although prevalence remains generally lower than in the West. As the prevalence of UC rises, so will overall healthcare costs. Disparities in healthcare systems and funding mean that different Asian countries face unique challenges in how best to use available resources, including selection from a growing number of emerging treatment options. More clinical trial and real-world data are required to help define treatment approaches that will most benefit Asian populations.
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Affiliation(s)
- Shu-Chen Wei
- Department of Internal Medicine, National Taiwan University Hospital , Taipei, Taiwan
| | - Jose Sollano
- Faculty of Medicine and Surgery, University of Santo Tomas , Manila, Philippines
| | - Yee Tak Hui
- Department of Medicine, Queen Elizabeth Hospital , Hong Kong, Hong Kong
| | - Wei Yu
- Pfizer Inc , Beijing, China
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Rajbhandari R, Blakemore S, Gupta N, Adler AJ, Noble CA, Mannan S, Nikolli K, Yih A, Joshi S, Bukhman G. Crohn’s disease in low and lower-middle income countries: A scoping review. World J Gastroenterol 2020; 26:6891-6908. [PMID: 33268969 PMCID: PMC7684456 DOI: 10.3748/wjg.v26.i43.6891] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 09/04/2020] [Accepted: 10/20/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND While Crohn’s disease has been studied extensively in high-income countries, its epidemiology and care in low and lower-middle income countries (LLMICs) is not well established due to a lack of disease registries and diagnostic capacity.
AIM To describe the published burden, diagnostic/treatment capacity, service utilization, challenges/barriers to individuals with Crohn’s in LLMICs and their providers.
METHODS We conducted a scoping review utilizing a full search strategy was developed and conducted in PubMed, Embase and World Health Organization Global Index Medicus. Two independent reviewers screened the titles and abstracts of all of the publications found in this search, reviewed selected publications, and extracted relevant data, which underwent descriptive review and was analyzed in Excel.
RESULTS The database search yielded 4486 publications, 216 of which were determined to be relevant to the research questions. Of all 79 LLMICs, only 21 (26.6%) have publications describing individuals with Crohn’s. Overall, the highest number of studies came from India, followed by Tunisia, and Egypt. The mean number of Crohn’s patients reported per study is 57.84 and the median is 22, with a wide range from one to 980.
CONCLUSION This scoping review has shown that, although there is a severe lack of population-based data about Crohn’s in LLMICs, there is a signal of Crohn’s in these settings around the world.
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Affiliation(s)
- Ruma Rajbhandari
- Division of Global Health Equity, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, United States
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02199, United States
| | - Samantha Blakemore
- Division of Global Health Equity, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, United States
| | - Neil Gupta
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02199, United States
- Partners in Health, NCD Synergies, Boston, MA 02199, United States
| | - Alma J Adler
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02199, United States
| | - Christopher Allen Noble
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02199, United States
- Partners in Health, NCD Synergies, Boston, MA 02199, United States
| | - Sara Mannan
- Division of Global Health Equity, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, United States
| | - Klejda Nikolli
- Division of Global Health Equity, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, United States
| | - Alison Yih
- Division of Global Health Equity, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, United States
| | - Sameer Joshi
- Western Reserve Health Education, Trumbull Regional Medical Center, Warren, OH 44483, United States
| | - Gene Bukhman
- Division of Global Health Equity, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, United States
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02199, United States
- Partners in Health, NCD Synergies, Boston, MA 02199, United States
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