{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,8]],"date-time":"2026-11-08T09:14:11Z","timestamp":1794129251678,"version":"4.8.0"},"reference-count":43,"publisher":"Springer Science and Business Media LLC","issue":"12","license":[{"start":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T00:00:00Z","timestamp":1696464000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T00:00:00Z","timestamp":1696464000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"funder":[{"DOI":"10.13039\/100016040","name":"Takeda Canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016040","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Dig Dis Sci"],"published-print":{"date-parts":[[2023,12]]},"DOI":"10.1007\/s10620-023-08096-9","type":"journal-article","created":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T11:01:43Z","timestamp":1696503703000},"page":"4350-4359","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Perianal Fistulas Are Associated with Persistently Higher Direct Health Care Costs in Crohn\u2019s Disease: A Population-Based Study"],"prefix":"10.1007","volume":"68","author":[{"given":"Jeffrey D.","family":"McCurdy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johnny H.","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shane","family":"Golden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atif","family":"Kukaswadia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Sarah Power","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4747-4305","authenticated-orcid":false,"given":"Ryan","family":"Ward","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura E.","family":"Targownik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,10,5]]},"reference":[{"key":"8096_CR1","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1038\/s41575-020-00360-x","volume":"18","author":"GG Kaplan","year":"2021","unstructured":"Kaplan GG, Windsor JW. The four epidemiological stages in the global evolution of inflammatory bowel disease. Nat Rev Gastroenterol Hepatol 2021;18:56\u201366.","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"8096_CR2","doi-asserted-by":"publisher","first-page":"720","DOI":"10.1038\/nrgastro.2015.150","volume":"12","author":"GG Kaplan","year":"2015","unstructured":"Kaplan GG. The global burden of IBD: from 2015 to 2025. Nat Rev Gastroenterol Hepatol 2015;12:720\u2013727.","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"8096_CR3","doi-asserted-by":"publisher","first-page":"S17","DOI":"10.1093\/jcag\/gwy055","volume":"2","author":"ME Kuenzig","year":"2019","unstructured":"Kuenzig ME, Benchimol EI, Lee L et al. The Impact of Inflammatory Bowel Disease in Canada 2018: Direct Costs and Health Services Utilization. J Can Assoc Gastroenterol 2019;2:S17-s33.","journal-title":"J Can Assoc Gastroenterol"},{"key":"8096_CR4","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1016\/S2468-1253(20)30012-1","volume":"5","author":"J Burisch","year":"2020","unstructured":"Burisch J, Vardi H, Schwartz D et al. Health-care costs of inflammatory bowel disease in a pan-European, community-based, inception cohort during 5 years of follow-up: a population-based study. Lancet Gastroenterol Hepatol 2020;5:454\u2013464.","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"8096_CR5","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1093\/ecco-jcc\/jjz096","volume":"14","author":"B Lo","year":"2020","unstructured":"Lo B, Vind I, Vester-Andersen MK et al. Direct and Indirect Costs of Inflammatory Bowel Disease: Ten Years of Follow-up in a Danish Population-based Inception Cohort. J Crohns Colitis 2020;14:53\u201363.","journal-title":"J Crohns Colitis"},{"key":"8096_CR6","doi-asserted-by":"publisher","first-page":"693","DOI":"10.1111\/j.1365-2036.2010.04234.x","volume":"31","author":"RD Cohen","year":"2010","unstructured":"Cohen RD, Yu AP, Wu EQ et al. Systematic review: the costs of ulcerative colitis in Western countries. Aliment Pharmacol Ther 2010;31:693\u2013707.","journal-title":"Aliment Pharmacol Ther"},{"key":"8096_CR7","doi-asserted-by":"publisher","first-page":"128","DOI":"10.14309\/ajg.0000000000000503","volume":"115","author":"LE Targownik","year":"2020","unstructured":"Targownik LE, Kaplan GG, Witt J et al. Longitudinal Trends in the Direct Costs and Health Care Utilization Ascribable to Inflammatory Bowel Disease in the Biologic Era: Results From a Canadian Population-Based Analysis. Am J Gastroenterol 2020;115:128\u2013137.","journal-title":"Am J Gastroenterol"},{"key":"8096_CR8","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1136\/gutjnl-2019-318440","volume":"69","author":"SK Murthy","year":"2020","unstructured":"Murthy SK, Begum J, Benchimol EI et al. Introduction of anti-TNF therapy has not yielded expected declines in hospitalisation and intestinal resection rates in inflammatory bowel diseases: a population-based interrupted time series study. Gut 2020;69:274\u2013282.","journal-title":"Gut"},{"key":"8096_CR9","doi-asserted-by":"publisher","first-page":"875","DOI":"10.1053\/gast.2002.32362","volume":"122","author":"DA Schwartz","year":"2002","unstructured":"Schwartz DA, Loftus EV Jr, Tremaine WJ et al. The natural history of fistulizing Crohn\u2019s disease in Olmsted County. Minnesota. Gastroenterology 2002;122:875\u2013880.","journal-title":"Minnesota. Gastroenterology"},{"key":"8096_CR10","doi-asserted-by":"crossref","unstructured":"Wewer MD, Zhao M, Nordholm-Carstensen A, et al. The Incidence and Disease Course of Perianal Crohn's Disease: A Danish Nationwide Cohort Study, 1997\u20132015. J Crohns Colitis 2020.","DOI":"10.1093\/ecco-jcc\/jjaa118"},{"key":"8096_CR11","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1080\/17474124.2019.1608818","volume":"13","author":"N Lopez","year":"2019","unstructured":"Lopez N, Ramamoorthy S, Sandborn WJ. Recent advances in the management of perianal fistulizing Crohn\u2019s disease: lessons for the clinic. Expert Rev Gastroenterol Hepatol 2019;13:563\u2013577.","journal-title":"Expert Rev Gastroenterol Hepatol"},{"key":"8096_CR12","doi-asserted-by":"publisher","first-page":"652","DOI":"10.1038\/nrgastro.2017.104","volume":"14","author":"J Pan\u00e9s","year":"2017","unstructured":"Pan\u00e9s J, Rimola J. Perianal fistulizing Crohn\u2019s disease: pathogenesis, diagnosis and therapy. Nat Rev Gastroenterol Hepatol 2017;14:652\u2013664.","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"8096_CR13","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1080\/17474124.2018.1480936","volume":"12","author":"O Rackovsky","year":"2018","unstructured":"Rackovsky O, Hirten R, Ungaro R et al. Clinical updates on perianal fistulas in Crohn\u2019s disease. Expert Rev Gastroenterol Hepatol 2018;12:597\u2013605.","journal-title":"Expert Rev Gastroenterol Hepatol"},{"key":"8096_CR14","doi-asserted-by":"publisher","first-page":"3400","DOI":"10.1007\/s10620-013-2830-7","volume":"58","author":"M Chaparro","year":"2013","unstructured":"Chaparro M, Zanotti C, Burgue\u00f1o P et al. Health care costs of complex perianal fistula in Crohn\u2019s disease. Dig Dis Sci 2013;58:3400\u20133406.","journal-title":"Dig Dis Sci"},{"key":"8096_CR15","doi-asserted-by":"publisher","first-page":"1955","DOI":"10.1111\/j.1572-0241.2000.02261.x","volume":"95","author":"BG Feagan","year":"2000","unstructured":"Feagan BG, Vreeland MG, Larson LR et al. Annual cost of care for Crohn\u2019s disease: a payor perspective. Am J Gastroenterol 2000;95:1955\u20131960.","journal-title":"Am J Gastroenterol"},{"key":"8096_CR16","first-page":"11","volume":"125","author":"M Lion","year":"2012","unstructured":"Lion M, Gearry RB, Day AS et al. The cost of paediatric and perianal Crohn\u2019s disease in Canterbury, New Zealand. N Z Med J 2012;125:11\u201320.","journal-title":"N Z Med J"},{"key":"8096_CR17","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1016\/j.crohns.2007.08.004","volume":"1","author":"S Odes","year":"2007","unstructured":"Odes S, Vardi H, Friger M et al. Effect of phenotype on health care costs in Crohn\u2019s disease: A European study using the Montreal classification. J Crohns Colitis 2007;1:87\u201396.","journal-title":"J Crohns Colitis"},{"key":"8096_CR18","doi-asserted-by":"publisher","first-page":"870","DOI":"10.1093\/ibd\/izab198","volume":"28","author":"G Chen","year":"2022","unstructured":"Chen G, Pedarla V, Null KD et al. Health Care Costs and Resource Utilization Among Patients With Crohn\u2019s Disease With and Without Perianal Fistula. Inflamm Bowel Dis 2022;28:870\u2013877.","journal-title":"Inflamm Bowel Dis"},{"key":"8096_CR19","doi-asserted-by":"publisher","first-page":"432","DOI":"10.1080\/00365521.2021.2016944","volume":"57","author":"RD Hirsch","year":"2022","unstructured":"Hirsch RD, Keung C, Con D et al. Direct health care costs of managing perianal Crohn\u2019s Disease in a population based cohort. Scand J Gastroenterol 2022;57:432\u2013438.","journal-title":"Scand J Gastroenterol"},{"key":"8096_CR20","doi-asserted-by":"publisher","first-page":"1490","DOI":"10.1136\/gut.2009.188383","volume":"58","author":"EI Benchimol","year":"2009","unstructured":"Benchimol EI, Guttmann A, Griffiths AM et al. Increasing incidence of paediatric inflammatory bowel disease in Ontario, Canada: evidence from health administrative data. Gut 2009;58:1490\u20131497.","journal-title":"Gut"},{"key":"8096_CR21","doi-asserted-by":"publisher","first-page":"887","DOI":"10.1016\/j.jclinepi.2014.02.019","volume":"67","author":"EI Benchimol","year":"2014","unstructured":"Benchimol EI, Guttmann A, Mack DR et al. Validation of international algorithms to identify adults with inflammatory bowel disease in health administrative data from Ontario, Canada. J Clin Epidemiol 2014;67:887\u2013896.","journal-title":"J Clin Epidemiol"},{"key":"8096_CR22","doi-asserted-by":"crossref","unstructured":"Jehovan Fairclough TT, Moses Fung, Shane Golden, Atif Kukaswadia, G Sarah Power, Ryan Ward and Jeff McCurdy MD, PhD. Perianal Crohn\u2019s Disease can be Accurately Identified Using Administrative Data Journal of the Canadian Association of Gastroenterology 2020;Volume 3:Pages 130\u2013131.","DOI":"10.1093\/jcag\/gwz047.252"},{"key":"8096_CR23","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1503\/cmaj.150064","volume":"188","author":"WP Wodchis","year":"2016","unstructured":"Wodchis WP, Austin PC, Henry DA. A 3-year study of high-cost users of health care. Cmaj 2016;188:182\u2013188.","journal-title":"Cmaj"},{"key":"8096_CR24","doi-asserted-by":"publisher","first-page":"1707","DOI":"10.1002\/ibd.20530","volume":"14","author":"RD Cohen","year":"2008","unstructured":"Cohen RD, Waters HC, Tang B et al. Effects of fistula on healthcare costs and utilization for patients with Crohn\u2019s disease treated in a managed care environment. Inflamm Bowel Dis 2008;14:1707\u20131714.","journal-title":"Inflamm Bowel Dis"},{"key":"8096_CR25","doi-asserted-by":"publisher","first-page":"1201","DOI":"10.1093\/ibd\/izaa270","volume":"27","author":"DT Rubin","year":"2021","unstructured":"Rubin DT, Griffith J, Zhang Q et al. The Impact of Intestinal Complications on Health Care Costs Among Patients With Inflammatory Bowel Disease Treated With Anti-Tumor Necrosis Factor Therapies. Inflamm Bowel Dis 2021;27:1201\u20131209.","journal-title":"Inflamm Bowel Dis"},{"key":"8096_CR26","doi-asserted-by":"publisher","first-page":"2779","DOI":"10.1016\/S0140-6736(17)32641-7","volume":"390","author":"JF Colombel","year":"2018","unstructured":"Colombel JF, Panaccione R, Bossuyt P et al. Effect of tight control management on Crohn\u2019s disease (CALM): a multicentre, randomised, controlled phase 3 trial. Lancet 2018;390:2779\u20132789.","journal-title":"Lancet"},{"key":"8096_CR27","doi-asserted-by":"publisher","first-page":"660","DOI":"10.1016\/S0140-6736(08)60304-9","volume":"371","author":"G D'Haens","year":"2008","unstructured":"D\u2019Haens G, Baert F, van Assche G et al. Early combined immunosuppression or conventional management in patients with newly diagnosed Crohn\u2019s disease: an open randomised trial. Lancet 2008;371:660\u2013667.","journal-title":"Lancet"},{"key":"8096_CR28","doi-asserted-by":"publisher","first-page":"3066","DOI":"10.1007\/s10620-019-05635-1","volume":"64","author":"P Tandon","year":"2019","unstructured":"Tandon P, Rhee GG, Schwartz D et al. Strategies to Optimize Anti-tumor Necrosis Factor Therapy for Perianal Fistulizing Crohn\u2019s Disease: A Systematic Review. Dig Dis Sci 2019;64:3066\u20133077.","journal-title":"Dig Dis Sci"},{"key":"8096_CR29","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1080\/00365521.2019.1600014","volume":"54","author":"AS Strik","year":"2019","unstructured":"Strik AS, L\u00f6wenberg M, Buskens CJ et al. Higher anti-TNF serum levels are associated with perianal fistula closure in Crohn\u2019s disease patients. Scand J Gastroenterol 2019;54:453\u2013458.","journal-title":"Scand J Gastroenterol"},{"key":"8096_CR30","doi-asserted-by":"publisher","first-page":"933","DOI":"10.1111\/apt.13970","volume":"45","author":"AJ Yarur","year":"2017","unstructured":"Yarur AJ, Kanagala V, Stein DJ et al. Higher infliximab trough levels are associated with perianal fistula healing in patients with Crohn\u2019s disease. Aliment Pharmacol Ther 2017;45:933\u2013940.","journal-title":"Aliment Pharmacol Ther"},{"key":"8096_CR31","unstructured":"Patented Medicine Prices Review Board: Market Intelligence Report: Biologic Response Modifier Agents (http:\/\/www.pmprb-cepmb.gc.ca\/view.asp?ccid51286&ang5en)(2015) Accessed December 4, 2019."},{"key":"8096_CR32","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1136\/gutjnl-2013-304488","volume":"63","author":"P Dewint","year":"2014","unstructured":"Dewint P, Hansen BE, Verhey E et al. Adalimumab combined with ciprofloxacin is superior to adalimumab monotherapy in perianal fistula closure in Crohn\u2019s disease: a randomised, double-blind, placebo controlled trial (ADAFI). Gut 2014;63:292\u2013299.","journal-title":"Gut"},{"key":"8096_CR33","doi-asserted-by":"publisher","first-page":"1329","DOI":"10.1111\/j.1365-2036.2004.02247.x","volume":"20","author":"RL West","year":"2004","unstructured":"West RL, van der Woude CJ, Hansen BE et al. Clinical and endosonographic effect of ciprofloxacin on the treatment of perianal fistulae in Crohn\u2019s disease with infliximab: a double-blind placebo-controlled study. Aliment Pharmacol Ther 2004;20:1329\u20131336.","journal-title":"Aliment Pharmacol Ther"},{"key":"8096_CR34","doi-asserted-by":"publisher","first-page":"1860","DOI":"10.1097\/MIB.0000000000001243","volume":"23","author":"DA Schwartz","year":"2017","unstructured":"Schwartz DA, Wang A, Ozbay B et al. Comparison of Health Care Utilization and Costs Between Patients with Perianal Fistulizing Crohn\u2019s Disease Treated with Biologics with or Without Previous Seton Placement. Inflamm Bowel Dis 2017;23:1860\u20131866.","journal-title":"Inflamm Bowel Dis"},{"key":"8096_CR35","doi-asserted-by":"publisher","first-page":"719","DOI":"10.1111\/apt.15665","volume":"51","author":"C Chapuis-Biron","year":"2020","unstructured":"Chapuis-Biron C, Bourrier A, Nachury M et al. Vedolizumab for perianal Crohn\u2019s disease: a multicentre cohort study in 151 patients. Aliment Pharmacol Ther 2020;51:719\u2013727.","journal-title":"Aliment Pharmacol Ther"},{"key":"8096_CR36","doi-asserted-by":"crossref","unstructured":"Chapuis-Biron C, Kirchgesner J, Pariente B, et al. Ustekinumab for Perianal Crohn's Disease: The BioLAP Multicenter Study From the GETAID. Am J Gastroenterol 2020.","DOI":"10.14309\/ajg.0000000000000810"},{"key":"8096_CR37","doi-asserted-by":"publisher","first-page":"1334","DOI":"10.1053\/j.gastro.2017.12.020","volume":"154","author":"J Pan\u00e9s","year":"2018","unstructured":"Pan\u00e9s J, Garc\u00eda-Olmo D, Van Assche G et al. Long-term Efficacy and Safety of Stem Cell Therapy (Cx601) for Complex Perianal Fistulas in Patients With Crohn\u2019s Disease. Gastroenterology 2018;154:1334-1342.e4.","journal-title":"Gastroenterology"},{"key":"8096_CR38","doi-asserted-by":"publisher","first-page":"1281","DOI":"10.1016\/S0140-6736(16)31203-X","volume":"388","author":"J Pan\u00e9s","year":"2016","unstructured":"Pan\u00e9s J, Garc\u00eda-Olmo D, Van Assche G et al. Expanded allogeneic adipose-derived mesenchymal stem cells (Cx601) for complex perianal fistulas in Crohn\u2019s disease: a phase 3 randomised, double-blind controlled trial. Lancet 2016;388:1281\u20131290.","journal-title":"Lancet"},{"key":"8096_CR39","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1038\/s41575-018-0022-9","volume":"15","author":"H Khalili","year":"2018","unstructured":"Khalili H, Chan SSM, Lochhead P et al. The role of diet in the aetiopathogenesis of inflammatory bowel disease. Nat Rev Gastroenterol Hepatol 2018;15:525\u2013535.","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"8096_CR40","doi-asserted-by":"publisher","first-page":"1637","DOI":"10.1136\/gutjnl-2019-319505","volume":"69","author":"H Khalili","year":"2020","unstructured":"Khalili H, H\u00e5kansson N, Chan SS et al. Adherence to a Mediterranean diet is associated with a lower risk of later-onset Crohn\u2019s disease: results from two large prospective cohort studies. Gut 2020;69:1637\u20131644.","journal-title":"Gut"},{"key":"8096_CR41","doi-asserted-by":"publisher","first-page":"873","DOI":"10.1053\/j.gastro.2020.05.011","volume":"159","author":"CH Lo","year":"2020","unstructured":"Lo CH, Lochhead P, Khalili H et al. Dietary Inflammatory Potential and Risk of Crohn\u2019s Disease and Ulcerative Colitis. Gastroenterology 2020;159:873-883.e1.","journal-title":"Gastroenterology"},{"key":"8096_CR42","doi-asserted-by":"publisher","first-page":"1054","DOI":"10.1093\/ibd\/izy329","volume":"25","author":"SH Park","year":"2019","unstructured":"Park SH, Aniwan S, Scott Harmsen W et al. Update on the Natural Course of Fistulizing Perianal Crohn\u2019s Disease in a Population-Based Cohort. Inflamm Bowel Dis 2019;25:1054\u20131060.","journal-title":"Inflamm Bowel Dis"},{"key":"8096_CR43","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.7378","volume":"3","author":"J Adler","year":"2020","unstructured":"Adler J, Lin CC, Gadepalli SK et al. Association Between Steroid-Sparing Therapy and the Risk of Perianal Fistulizing Complications Among Young Patients With Crohn Disease. JAMA Netw Open 2020;3:e207378.","journal-title":"JAMA Netw Open"}],"container-title":["Digestive Diseases and Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10620-023-08096-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10620-023-08096-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10620-023-08096-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,9]],"date-time":"2023-11-09T09:08:52Z","timestamp":1699520932000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10620-023-08096-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,5]]},"references-count":43,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2023,12]]}},"alternative-id":["8096"],"URL":"https:\/\/doi.org\/10.1007\/s10620-023-08096-9","relation":{},"ISSN":["0163-2116","1573-2568"],"issn-type":[{"value":"0163-2116","type":"print"},{"value":"1573-2568","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,5]]},"assertion":[{"value":"16 January 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 August 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 October 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"JM: Consultancy fees and\/or honoraria: Janssen, Abbvie, Takeda, Pfizer. LT: Consultancy fees and\/or honoraria: Janssen, Abbvie, Takeda, Pfizer. RW and JC: employees of Takeda. AK, SG and GSP: employees of IQVIA who provided consulting services to Takeda.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interest"}}]}}