Sex-Based Disparities in Treatment and Healthcare Utilization in Patients with Ulcerative Colitis: A Systematic Review and Meta-Analysis

被引:0
作者
Shah, Yash R. [1 ]
Sebastian, Sneha Annie [2 ]
Dahiya, Dushyant Singh [3 ]
Gangwani, Manesh Kumar [4 ]
Satiya, Jinendra [5 ]
Rao, Adishwar [6 ]
Mansour, Ramy [7 ]
Ali, Hassam [8 ]
Al Ta'ani, Omar [9 ]
Inamdar, Sumant [4 ]
Ali, Meer A. [4 ]
Alomari, Mohammad [4 ]
机构
[1] Wayne State Univ, Dept Internal Med, Trinity Hlth Oakland, Pontiac, MI 48341 USA
[2] Azeezia Med Coll, Dept Internal Med, Kollam 691537, India
[3] Univ Kansas, Div Gastroenterol Hepatol & Motil, Sch Med, Kansas City, KS 66103 USA
[4] Univ Arkansas Med Sci, Dept Gastroenterol & Hepatol, Little Rock, AR 72205 USA
[5] Yuma Reg Med Ctr, Dept Internal Med, Yuma, AZ 85364 USA
[6] Guthrie Med Ctr, Dept Internal Med, Sayre, PA 18840 USA
[7] Trinity Hlth Oakland, Dept Gastroenterol & Hepatol, Pontiac, MI 48341 USA
[8] East Carolina Univ, Brody Sch Med, Div Gastroenterol Hepatol & Nutr, Greenville, NC 27858 USA
[9] Allegheny Hlth Network, Dept Internal Med, Pittsburgh, PA 15212 USA
关键词
ulcerative colitis; sex-based disparities; drug therapy; surgery; healthcare utilization; INFLAMMATORY-BOWEL-DISEASE; GENDER; NONADHERENCE;
D O I
10.3390/jcm13247534
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Sex-related treatment disparities are well-documented across various medical conditions, yet their impact on the management of inflammatory bowel disease (IBD) remains underexplored. This study aims to investigate sex-based differences in the management of ulcerative colitis (UC), focusing on both medical and surgical approaches and examining whether biological sex correlates with variations in healthcare utilization. Methods: A systematic search was conducted across multiple databases, including MEDLINE (via PubMed), Google Scholar, the Cochrane Library, and ScienceDirect, to identify studies on sex differences in ulcerative colitis (UC) management up to April 2024. Statistical analysis was performed using RevMan 5.4, with a random-effects model to combine odds ratios (OR) for both primary and secondary outcomes. The study is registered with PROSPERO (CRD42024537750). Results: The meta-analysis included eight observational studies involving 47,089 patients (51.9% females). There were no statistically significant sex differences in biologic therapy use (OR 0.89, 95% CI: 0.69 to 1.15, p = 0.36) or corticosteroid use (OR 1.17, 95% CI: 0.89 to 1.54, p = 0.27). However, females were less likely to use immunomodulators compared to males (OR 0.89, 95% CI: 0.85 to 0.94, p < 0.0001). There were no significant differences in surgical interventions, including total abdominal colectomy. Females had higher annual UC-related hospitalizations compared to males (OR 1.41, 95% CI: 1.22 to 1.64, p < 0.00001). Conclusions: In conclusion, while biologic and surgical treatments showed no significant sex differences, disparities were noted in immunomodulator use and hospitalization rates, underscoring the need for sex-specific UC management strategies.
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页数:14
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