{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T15:05:55Z","timestamp":1775487955229,"version":"3.50.1"},"reference-count":39,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,5,3]],"date-time":"2025-05-03T00:00:00Z","timestamp":1746230400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Sciences"],"abstract":"<jats:p>Background\/Objectives: Inflammatory bowel disease (IBD) includes Crohn\u2019s disease (CD) and ulcerative colitis (UC). The availability of an increasing number of new molecules approved for IBD treatment has increased our ability and aspirations to change the trajectory of the disease. The Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) II consensus (2018) is the current suggested strategy for IBD management, which recommends a treat-to-target approach. The primary objective of this study is to describe the clinical history of IBD in the post-STRIDE II era and to quantify the burden of IBD in terms of hospitalisation rate. The secondary objective is to estimate the 6-year risk of intestinal resection among IBD patients. Methods: A population-based time series analysis was conducted on administrative data; retrospective data from January 2011 to December 2021 were collected for the Local Health Authority \u201cRoma 1\u201d population (\u223c1.5 million residents). Hospitalisation and surgical events were prospectively recorded for patients newly diagnosed between January 2018 and February 2022 (n = 556), with follow-up throughout May 2024. A Kaplan\u2013Mayer survivor analysis was performed to estimate the cumulative surgery risk. Results: In 2021, the IBD prevalence was 218.3 cases\/100,000 people (77.2 CD, 141.1 UC). The incidence trend slowly increased during the last decade, up to 5.3 (CD) and 9.4 (UC) cases\/100,000 ppl\/year. The yearly hospitalisation rate remained stable, near 16.5%. The 6-year cumulative risk of surgery was 36% for CD and 20% for UC. Conclusions: The incidence of IBD has increased in the last few decades, with substantial stability in regard to the incidence of surgery and hospitalisations. Thus, the current IBD management approach has only had a small effect on changing the natural history of the disease.<\/jats:p>","DOI":"10.3390\/medsci13020055","type":"journal-article","created":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T20:10:27Z","timestamp":1746389427000},"page":"55","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Inflammatory Bowel Disease in the Post-STRIDE II Era: Epidemiology and Long-Term Clinical Outcomes from a Population-Based Study"],"prefix":"10.3390","volume":"13","author":[{"given":"Fabio","family":"Ingravalle","sequence":"first","affiliation":[{"name":"Doctoral School of Nursing Sciences and Public Health, University of Rome \u201cTor Vergata\u201d, 00133 Rome, Italy"},{"name":"Local Health Authority \u201cRoma 6\u201d, 00041 Albano Laziale, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Valvano","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Galliera Hospital, 16128 Genoa, Italy"},{"name":"Department of Life, Health, and Environmental Sciences, Division of Gastroenterology, Hepatology, and Nutrition, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Barbara","sequence":"additional","affiliation":[{"name":"Local Health Authority \u201cRoma 1\u201d, 00193 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorian","family":"Bardhi","sequence":"additional","affiliation":[{"name":"Health Management Unit, Azienda Ospedaliero Universitaria delle Marche, 60126 Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6341-5711","authenticated-orcid":false,"given":"Giovanni","family":"Latella","sequence":"additional","affiliation":[{"name":"Department of Life, Health, and Environmental Sciences, Division of Gastroenterology, Hepatology, and Nutrition, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8513-3758","authenticated-orcid":false,"given":"Angelo","family":"Viscido","sequence":"additional","affiliation":[{"name":"Department of Life, Health, and Environmental Sciences, Division of Gastroenterology, Hepatology, and Nutrition, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariachiara","family":"Campanale","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Galliera Hospital, 16128 Genoa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4915-7733","authenticated-orcid":false,"given":"Antonio","family":"Vinci","sequence":"additional","affiliation":[{"name":"Doctoral School of Nursing Sciences and Public Health, University of Rome \u201cTor Vergata\u201d, 00133 Rome, Italy"},{"name":"Local Health Authority \u201cRoma 1\u201d, 00193 Rome, Italy"},{"name":"Azienda Regionale Emergenza Sanitaria ARES 118, 00149 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlo","family":"Viora","sequence":"additional","affiliation":[{"name":"Local Health Authority \u201cRoma 1\u201d, 00193 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giampiera","family":"Bulfone","sequence":"additional","affiliation":[{"name":"Department of Medical, Surgical Science, and Advanced Technology \u201cGF Ingrassia\u201d, University of Catania, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1874-5233","authenticated-orcid":false,"given":"Rocco","family":"Mazzotta","sequence":"additional","affiliation":[{"name":"Department of Biomedicine and Prevention, University of Rome \u201cTor Vergata\u201d, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5884-161X","authenticated-orcid":false,"given":"Massimo","family":"Maurici","sequence":"additional","affiliation":[{"name":"Department of Biomedicine and Prevention, University of Rome \u201cTor Vergata\u201d, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"144K","DOI":"10.1093\/ecco-jcc\/jjy113","article-title":"ECCO-ESGAR Guideline for Diagnostic Assessment in IBD Part 1: Initial diagnosis, monitoring of known IBD, detection of complications","volume":"13","author":"Maaser","year":"2019","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"180","DOI":"10.3390\/gidisord4030017","article-title":"Fecal Calprotectin, Chitinase 3-Like-1, S100A12 and Osteoprotegerin as Markers of Disease Activity in Children with Crohn\u2019s Disease","volume":"4","author":"Volkers","year":"2022","journal-title":"Gastrointest. Disord."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1159\/000487589","article-title":"Multiparametric Evaluation Predicts Different Mid-Term Outcomes in Crohn\u2019s Disease","volume":"36","author":"Laterza","year":"2018","journal-title":"Dig. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"249","DOI":"10.3390\/gidisord4040024","article-title":"Intestinal Ultrasound in the Assessment of Luminal Crohn\u2019s Disease","volume":"4","author":"Bohra","year":"2022","journal-title":"Gastrointest. Disord."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Caviglia, G.P., Garrone, A., Bertolino, C., Vanni, R., Bretto, E., Poshnjari, A., Tribocco, E., Frara, S., Armandi, A., and Astegiano, M. (2023). Epidemiology of Inflammatory Bowel Diseases: A Population Study in a Healthcare District of North-West Italy. J. Clin. Med., 12.","DOI":"10.3390\/jcm12020641"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1038\/nrgastro.2015.150","article-title":"The global burden of IBD: From 2015 to 2025","volume":"12","author":"Kaplan","year":"2015","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2769","DOI":"10.1016\/S0140-6736(17)32448-0","article-title":"Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: A systematic review of population-based studies","volume":"390","author":"Ng","year":"2017","journal-title":"Lancet"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2211","DOI":"10.1016\/j.cgh.2022.06.030","article-title":"Global Hospitalization Trends for Crohn\u2019s Disease and Ulcerative Colitis in the 21st Century: A Systematic Review with Temporal Analyses","volume":"21","author":"Buie","year":"2023","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1111\/apt.17622","article-title":"Review article: Translating STRIDE-II into clinical reality\u2014Opportunities and challenges","volume":"58","author":"Dignass","year":"2023","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"183206","DOI":"10.1155\/2010\/183206","article-title":"Epidemiologic Determinants Affecting Cigarette Smoking Cessation: A Retrospective Study in a National Health System (SSN) Treatment Service in Rome (Italy)","volume":"2010","author":"Marino","year":"2010","journal-title":"J. Environ. Public Health"},{"key":"ref_11","first-page":"306","article-title":"The influence of work context and organizational well-being on psychophysical health of healthcare providers","volume":"111","author":"Zaghini","year":"2020","journal-title":"La Med. Del Lav."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"113","DOI":"10.25122\/jml-2018-0075","article-title":"A review of the diagnosis, prevention, and treatment methods of inflammatory bowel disease","volume":"12","author":"Seyedian","year":"2019","journal-title":"JMedLife"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Pietrantonio, F., Vinci, A., Maurici, M., Ciarambino, T., Galli, B., Signorini, A., La Fazia, V.M., Rosselli, F., Fortunato, L., and Iodice, R. (2023). Intra- and Extra-Hospitalization Monitoring of Vital Signs\u2014Two Sides of the Same Coin: Perspectives from LIMS and Greenline-HT Study Operators. Sensors, 23.","DOI":"10.3390\/s23125408"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Pietrantonio, F., Florczak, M., Kuhn, S., K\u00e4rberg, K., Leung, T., Said Criado, I., Sikorski, S., Ruggeri, M., Signorini, A., and Rosiello, F. (2024). Applications to augment patient care for Internal Medicine specialists: A position paper from the EFIM working group on telemedicine, innovative technologies & digital health. Front. Public Health, 12.","DOI":"10.3389\/fpubh.2024.1370555"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1531","DOI":"10.1093\/ecco-jcc\/jjae091","article-title":"ECCO Guidelines on Therapeutics in Crohn\u2019s Disease: Medical Treatment","volume":"18","author":"Gordon","year":"2024","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1093\/ecco-jcc\/jjab178","article-title":"ECCO Guidelines on Therapeutics in Ulcerative Colitis: Medical Treatment","volume":"16","author":"Raine","year":"2022","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Vinci, A., Ingravalle, F., Bardhi, D., Cesaro, N., Frassino, S., Licata, F., and Valvano, M. (2022). Cannabinoid Therapeutic Effects in Inflammatory Bowel Diseases: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Biomedicines, 10.","DOI":"10.3390\/biomedicines10102439"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"263","DOI":"10.3390\/gidisord4040025","article-title":"Neutrophils in Intestinal Inflammation: What We Know and What We Could Expect for the Near Future","volume":"4","author":"Arosa","year":"2022","journal-title":"Gastrointest. Disord."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Viscido, A., Valvano, M., Stefanelli, G., Capannolo, A., Castellini, C., Onori, E., Ciccone, A., Vernia, F., and Latella, G. (2022). Systematic review and meta-analysis: The advantage of endoscopic Mayo score 0 over 1 in patients with ulcerative colitis. BMC Gastroenterol., 22.","DOI":"10.1186\/s12876-022-02157-5"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2052","DOI":"10.1016\/j.dld.2024.05.026","article-title":"Factors correlated with transmural healing in patients with Crohn\u2019s disease in long-term clinical remission on anti-TNF medication","volume":"56","author":"Maconi","year":"2024","journal-title":"Dig. Liver Dis."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1324","DOI":"10.1038\/ajg.2015.233","article-title":"Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE): Determining Therapeutic Goals for Treat-to-Target","volume":"110","author":"Sandborn","year":"2015","journal-title":"Am. J. Gastroenterol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1570","DOI":"10.1053\/j.gastro.2020.12.031","article-title":"STRIDE-II: An Update on the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) Initiative of the International Organization for the Study of IBD (IOIBD): Determining Therapeutic Goals for Treat-to-Target strategies in IBD","volume":"160","author":"Turner","year":"2021","journal-title":"Gastroenterology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"175","DOI":"10.3390\/gidisord2020019","article-title":"Vaccination in Inflammatory Bowel Disease: Utility and Future Perspective","volume":"2","author":"Casella","year":"2020","journal-title":"Gastrointest. Disord."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"77","DOI":"10.3390\/gidisord4020009","article-title":"Response to COVID-19 Vaccination in Patients with Inflammatory Bowel Disease on Biological Treatment","volume":"4","author":"Bodini","year":"2022","journal-title":"Gastrointest. Disord."},{"key":"ref_25","unstructured":"(2025, April 29). Definizione e Aggiornamento dei Livelli Essenziali di Assistenza, di cui all\u2019articolo 1, Comma 7, del Decreto Legislativo 30 Dicembre. Decreto del Presidente del Consiglio dei Ministri. Sect. All. 8, G.U. Serie Generale n. 65, Available online: https:\/\/www.trovanorme.salute.gov.it\/norme\/dettaglioAtto?id=58669&completo=true."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1108\/JHOM-10-2019-0295","article-title":"Managerial workarounds in three European DRG systems","volume":"34","author":"Sheaff","year":"2020","journal-title":"J. Health Organ. Manag."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Nicholls, S.G., Quach, P., von Elm, E., Guttmann, A., Moher, D., Petersen, I., S\u00f8rensen, H.T., Smeeth, L., Langan, S.M., and Benchimol, E.I. (2015). The REporting of Studies Conducted Using Observational Routinely-Collected Health Data (RECORD) Statement: Methods for Arriving at Consensus and Developing Reporting Guidelines. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0125620"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Furia, G., Vinci, A., Colamesta, V., Papini, P., Grossi, A., Cammalleri, V., Chierchini, P., Maurici, M., Damiani, G., and De Vito, C. (2023). Appropriateness of frequent use of emergency departments: A retrospective analysis in Rome, Italy. Front. Public Health, 11.","DOI":"10.3389\/fpubh.2023.1150511"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1136\/gutjnl-2019-318440","article-title":"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","volume":"69","author":"Murthy","year":"2020","journal-title":"Gut"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2406","DOI":"10.1007\/s10620-014-3174-7","article-title":"Accuracy of Diagnostic Codes for Identifying Patients with Ulcerative Colitis and Crohn\u2019s Disease in the Veterans Affairs Health Care System","volume":"59","author":"Hou","year":"2014","journal-title":"Dig. Dis. Sci."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1162\/003465399558454","article-title":"Measuring Business Cycles: Approximate Band-Pass Filters for Economic Time Series","volume":"81","author":"Baxter","year":"1999","journal-title":"Rev. Econ. Stat."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1053\/j.gastro.2021.12.282","article-title":"Twenty-first Century Trends in the Global Epidemiology of Pediatric-Onset Inflammatory Bowel Disease: Systematic Review","volume":"162","author":"Kuenzig","year":"2022","journal-title":"Gastroenterology"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e065186","DOI":"10.1136\/bmjopen-2022-065186","article-title":"Global, regional and national burden of inflammatory bowel disease in 204 countries and territories from 1990 to 2019: A systematic analysis based on the Global Burden of Disease Study 2019","volume":"13","author":"Wang","year":"2023","journal-title":"BMJ Open"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1007\/s12328-019-01037-y","article-title":"Relationship(s) between obesity and inflammatory bowel diseases: Possible intertwined pathogenic mechanisms","volume":"13","author":"Szilagyi","year":"2020","journal-title":"Clin. J. Gastroenterol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1038\/ajg.2009.579","article-title":"The Natural History of Adult Crohn\u2019s Disease in Population-Based Cohorts","volume":"105","author":"Loftus","year":"2010","journal-title":"Am. J. Gastroenterol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1430","DOI":"10.1016\/j.cgh.2007.09.002","article-title":"Clinical Course in Crohn\u2019s Disease: Results of a Norwegian Population-Based Ten-Year Follow-Up Study","volume":"5","author":"Solberg","year":"2007","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1093\/ecco-jcc\/jjaa044","article-title":"Temporal Trends in Surgical Resection Rates and Biologic Prescribing in Crohn\u2019s Disease: A Population-based Cohort Study","volume":"14","author":"Jenkinson","year":"2020","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Valvano, M., Vinci, A., Cesaro, N., Frassino, S., Ingravalle, F., Ameli, M., Viscido, A., Necozione, S., and Latella, G. (2023). The long-term effect on surgery-free survival of biological compared to conventional therapy in Crohn\u2019s disease in real world-data: A retrospective study. BMC Gastroenterol., 23.","DOI":"10.1186\/s12876-023-03074-x"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1579","DOI":"10.1111\/apt.18001","article-title":"Crohn\u2019s disease after surgery: Changes in post-operative management strategies over time and their impact on long-term re-operation rate\u2014A retrospective multicentre real-world study","volume":"59","author":"Aratari","year":"2024","journal-title":"Aliment. Pharmacol. Ther."}],"container-title":["Medical Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3271\/13\/2\/55\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:26:45Z","timestamp":1760030805000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3271\/13\/2\/55"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,3]]},"references-count":39,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["medsci13020055"],"URL":"https:\/\/doi.org\/10.3390\/medsci13020055","relation":{},"ISSN":["2076-3271"],"issn-type":[{"value":"2076-3271","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,3]]}}}