{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T06:33:23Z","timestamp":1792218803970,"version":"4.4.0"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,3,20]],"date-time":"2023-03-20T00:00:00Z","timestamp":1679270400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,3,20]],"date-time":"2023-03-20T00:00:00Z","timestamp":1679270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100015756","name":"Janssen-Cilag","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100015756","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Colorectal Dis"],"abstract":"<jats:title>Abstract\n<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>The aim of this study was to investigate the burden of disease among a real-world cohort of patients with prevalent Crohn\u2019s disease (CD) in Germany.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We conducted a retrospective cohort analysis using administrative claims data from the German AOK PLUS health insurance fund. Continuously insured patients with a CD diagnosis between 01 October 2014 and 31 December 2018 were selected and followed for at least 12\u00a0months or longer until death or end of data availability on 31 December 2019. Medication use (biologics, immunosuppressants (IMS), steroids, 5-aminosalicylic acid) was assessed sequentially in the follow-up period. Among patients with no IMS or biologics (advanced therapy), we investigated indicators of active disease and corticosteroid use.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Overall, 9284 prevalent CD patients were identified. Within the study period, 14.7% of CD patients were treated with biologics and 11.6% received IMS. Approximately 47% of all prevalent CD patients had mild disease, defined as no advanced therapy and signs of disease activity. Of 6836 (73.6%) patients who did not receive advanced therapy in the follow-up period, 36.3% showed signs of active disease; 40.1% used corticosteroids (including oral budesonide), with 9.9% exhibiting steroid dependency (\u2265\u20091 prescription every 3\u00a0months for at least 12\u00a0months) in the available follow-up.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This study suggests that there remains a large burden of disease among patients who do not receive IMS or biologics in the real world in Germany. A revision of treatment algorithms of patients in this setting according to the latest guidelines may improve patient outcomes.\n<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00384-023-04368-y","type":"journal-article","created":{"date-parts":[[2023,3,20]],"date-time":"2023-03-20T08:03:55Z","timestamp":1679299435000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Burden of disease among patients with prevalent Crohn\u2019s disease: results from a large German sickness fund"],"prefix":"10.1007","volume":"38","author":[{"given":"Evi","family":"Zhuleku","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz","family":"Antolin-Fontes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andras","family":"Borsi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riikka","family":"Nissinen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivana","family":"Bravat\u00e0","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer Norma","family":"Barthelmes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alun","family":"Passey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Wirth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulf","family":"Maywald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernd","family":"Bokemeyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Wilke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Ghiani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,3,20]]},"reference":[{"issue":"10080","key":"4368_CR1","doi-asserted-by":"publisher","first-page":"1741","DOI":"10.1016\/S0140-6736(16)31711-1","volume":"389","author":"J Torres","year":"2017","unstructured":"Torres J et al (2017) Crohn\u2019s disease. Lancet 389(10080):1741\u20131755","journal-title":"Lancet"},{"issue":"2","key":"4368_CR2","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1038\/ajg.2009.579","volume":"105","author":"L Peyrin-Biroulet","year":"2010","unstructured":"Peyrin-Biroulet L et al (2010) The natural history of adult Crohn\u2019s disease in population-based cohorts. Am J Gastroenterol 105(2):289\u2013297","journal-title":"Am J Gastroenterol"},{"issue":"1","key":"4368_CR3","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1093\/ecco-jcc\/jjz180","volume":"14","author":"J Torres","year":"2020","unstructured":"Torres J et al (2020) ECCO guidelines on therapeutics in Crohn\u2019s disease: medical treatment. J Crohns Colitis 14(1):4\u201322","journal-title":"J Crohns Colitis"},{"issue":"3","key":"4368_CR4","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1055\/a-1713-3941","volume":"60","author":"A Sturm","year":"2022","unstructured":"Sturm A et al (2022) Updated S3 guideline \u201cDiagnosis and therapy of Morbus Crohn\u201d of the German Society for Gastroenterology, Digestive and metabolic diseases (DGVS). Z Gastroenterol 60(3):332\u2013418","journal-title":"Z Gastroenterol"},{"issue":"8","key":"4368_CR5","doi-asserted-by":"publisher","first-page":"1587","DOI":"10.1007\/s00384-020-03588-w","volume":"35","author":"B Bokemeyer","year":"2020","unstructured":"Bokemeyer B et al (2020) Indicators of active disease and steroid dependency in patients with inflammatory bowel diseases not treated with biologics in a German real-world-setting. Int J Colorectal Dis 35(8):1587\u20131598","journal-title":"Int J Colorectal Dis"},{"key":"4368_CR6","doi-asserted-by":"crossref","unstructured":"Brunet E et al (2020) Time trends of Crohn\u2019s disease in Catalonia from 2011 to 2017. Increasing use of biologics correlates with a reduced need for surgery. J Clin Med 9(9)","DOI":"10.3390\/jcm9092896"},{"issue":"5","key":"4368_CR7","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1111\/apt.16723","volume":"55","author":"M Zhao","year":"2022","unstructured":"Zhao M et al (2022) Trends in the use of biologicals and their treatment outcomes among patients with inflammatory bowel diseases \u2013 a Danish nationwide cohort study. Aliment Pharmacol Ther 55(5):541\u2013557","journal-title":"Aliment Pharmacol Ther"},{"key":"4368_CR8","doi-asserted-by":"crossref","unstructured":"Anisdahl K et al (2019) P710 The use of first-line biologics in patients with Crohn\u2019s disease in Norway from 2011 to 2016. 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Int J Colorectal Dis 36(11):2419\u20132426","journal-title":"Int J Colorectal Dis"}],"container-title":["International Journal of Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00384-023-04368-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00384-023-04368-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00384-023-04368-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,21]],"date-time":"2023-12-21T11:14:22Z","timestamp":1703157262000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00384-023-04368-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,20]]},"references-count":13,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["4368"],"URL":"https:\/\/doi.org\/10.1007\/s00384-023-04368-y","relation":{},"ISSN":["1432-1262"],"issn-type":[{"value":"1432-1262","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,20]]},"assertion":[{"value":"6 March 2023","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 March 2023","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Due to the non-interventional, retrospective study design using fully anonymized data, ethics approval was not required for this study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Due to the non-interventional, retrospective study design using fully anonymized data, informed consent was not required for this study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"EZ and BAF are employees of Cytel. The work of Cytel was sponsored by Janssen-Cilag. AB, RN, IB, JNB, JL, AP, and DW are employees of Janssen-Cilag. UM is an employee of AOK PLUS and declares no conflicts of interest. BB has received consulting fees from Abbvie, MSD, Shire, Ferring, UCB, Hospira, Takeda, Movetis, Shield Therapeutics, Pfizer, Biogen, Janssen, Hexal, Cellgene, Boehringer, Allergan, Galapagos, and Arena; provided speeches\/lectures for Abbvie, Ferring, MSD, Merckle, Falk, HLR, UCB, Shield Therapeutics, Pfizer, Celltrion, Takeda, Janssen, Mundipharma, and Arena; and received research grants from Abbvie, Ferring, UCB, Given Imaging, Janssen, Takeda, Pfizer, and Galapagos. TW is a staff member of IPAM e.V. and has received honoraria from several pharmaceutical\/consultancy firms, e.g., Novo Nordisk, Abbvie, Merck, GSK, BMS, LEOPharma, Bayer, Boehringer Ingelheim. MG is an employee of Cytel and staff member of IPAM e.V.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"74"}}