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Monday Poster Session

Category: Functional Bowel Disease

P1947 - Burden of Anal/Rectal-Related Adverse Consequences Associated with Chronic Straining Among Patients with Irritable Bowel Syndrome And/Or Constipation

Monday, October 23, 2023
10:30 AM – 4:15 PM PT
Location: Exhibit Hall
Has Audio
ACG Outstanding Poster Presenter
Douglas CA Taylor, MBA1, Yanqing Xu, PhD2, Katherine J. Kosch, RPh2, Yi Liang, PhD2, Phuong T. Tran, MPH2, Magnus Simrén, MD, PhD3, William D. Chey, MD, FACG4
1Former Employee of Ironwood Pharmaceuticals, Inc., Boston, MA; 2AbbVie Inc., North Chicago, IL; 3University of Gothenburg, University of North Carolina, Gothenburg, Gotlands Lan, Sweden; 4University of Michigan, Ann Arbor, MI

Introduction: Irritable bowel syndrome (IBS) without predominant diarrhea and chronic idiopathic constipation (CIC) are common disorders of gut–brain interaction characterized by infrequent hard-to-pass stools and varying degrees of abdominal pain and/or discomfort. This study compared rates of anal/rectal-related adverse consequences commonly associated with chronic straining and their associated health care utilization and costs among patients with IBS and/or CIC vs matched controls without those conditions.

Methods: Data for this retrospective cohort study were derived from health insurance claims from patients enrolled in commercial and Medicare Advantage plans within the Merative™ MarketScan® Databases (MSD) and the Optum Clinformatics® Data Mart (CDM). IBS and CIC patients ≥ 18 years old at index date were identified for the study if they had ≥ 2 medical claims with an ICD-10 code of IBS or constipation during the study and were continuously enrolled in their insurance plan for 6 months pre- and 12 months post-index. Patients were matched 1:5 with controls (without IBS/CIC) on age, sex, region, Charlson Comorbidity Index, and index date. Anal/rectal events studied were hemorrhoids, anal/rectal prolapse, anal fissure, and fecal impaction. Analyses included proportion of events, health care utilization, and cost for anal/rectal-related adverse consequences in the 12 months after index.

Results: A total of 58,483 IBS and 154,007 CIC patients were identified in the MSD and matched to 292,415 and 770,035 controls. Corresponding numbers for the CDM were 48,248, 162,087, 241,240, and 810,435, respectively. Overall patients and controls were well matched demographically within each database. The mean age in the CDM was higher vs MSD due to a higher proportion of Medicare patients. Overall, IBS and CIC cases in both datasets had higher proportion of events vs controls; the most common event was hemorrhoids. IBS and CIC cases in both datasets had higher costs vs controls on both a per-patient and a per-utilization basis. Across both datasets, costs were generally similar for IBS and CIC (Table).

Discussion: Patients with IBS or CIC had significantly higher rates of hemorrhoids, anal/rectal prolapse, anal fissures, and fecal impaction vs matched controls. These events were associated with increased costs in both the IBS and CIC populations as a whole and on a per-event basis primarily driven by outpatient care.


Disclosures:
Douglas CA Taylor: Ironwood Pharmaceuticals Inc. – Stock Options.
Yanqing Xu: AbbVie Inc. – Employee, Stock Options.
Katherine Kosch: AbbVie, Inc. – Employee, Stock Options.
Yi Liang: AbbVie, Inc. – Independent Contractor.
Phuong T. Tran indicated no relevant financial relationships.
Magnus Simrén: AbbVie, Inc. – Advisory Committee/Board Member. Arena Pharmaceuticals, Inc. – Advisory Committee/Board Member. Biocodex – Advisory Committee/Board Member, Speakers Bureau. BioGaia – Advisory Committee/Board Member, Speakers Bureau. Danone Nutricia Research – Advisory Committee/Board Member. DSM – Advisory Committee/Board Member, Grant/Research Support. Falk Foundation – Speakers Bureau. Ferrer – Speakers Bureau. Genetic Analysis AS – Advisory Committee/Board Member, Grant/Research Support. Glycom – Grant/Research Support. Ironwood Pharmaceuticals Inc. – Advisory Committee/Board Member. Janssen Immunology – Speakers Bureau. Kyowa Kirin – Advisory Committee/Board Member, Speakers Bureau. Pfizer Inc. – Speakers Bureau. Pharmanovia – Advisory Committee/Board Member. Sanofi – Speakers Bureau. Takeda – Advisory Committee/Board Member, Speakers Bureau. Tillotts – Advisory Committee/Board Member, Speakers Bureau.
William Chey: AbbVie, Inc. – Consultant. Ardelyx – Consultant. Biomerica – Consultant. Commonwealth Diagnostics International – Grant/Research Support. Digital Manometry – Intellectual Property/Patents. Gemelli – Consultant. Ironwood – Consultant. Isothrive – Consultant, Stock Options. Kiwi BioScience – Stock Options. Modify Health – Stock Options. My Nutrition Health – Intellectual Property/Patents. Nestle – Consultant. QOL Medical – Consultant, Grant/Research Support. Rectal Expulsion Device – Intellectual Property/Patents. Redhill – Consultant. Salix/Valeant – Consultant, Grant/Research Support. Takeda – Consultant. Urovant Sciences – Consultant. Vibrant – Consultant.


Douglas CA Taylor, MBA1, Yanqing Xu, PhD2, Katherine J. Kosch, RPh2, Yi Liang, PhD2, Phuong T. Tran, MPH2, Magnus Simrén, MD, PhD3, William D. Chey, MD, FACG4. P1947 - Burden of Anal/Rectal-Related Adverse Consequences Associated with Chronic Straining Among Patients with Irritable Bowel Syndrome And/Or Constipation, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.