Medication-wide study: Exploring Medication Use 10 Years Before a Diagnosis of Inflammatory Bowel Disease

Linéa Bonfils*, Anastasia Karachalia Sandri, Gry J. Poulsen, Manasi Agrawal, Daniel J. Ward, Jean-Frederic Colombel, Tine Jess, Kristine H. Allin

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

1 Citation (Scopus)


Introduction: There is growing interest in the prediagnostic phase of inflammatory bowel disease (IBD) and in the overlap of IBD with other diseases. We described and compared use of any prescription medication between individuals with and without IBD in a 10-year period preceding diagnosis.

Methods: Based on cross-linked nationwide registers, we identified 29,219 individuals diagnosed with IBD in Denmark between 2005 and 2018 and matched to 292,190 IBD-free individuals. The primary outcome was use of any prescription medication in years 1-10 before IBD diagnosis/matching date. Participants were considered as medication users if they redeemed ≥1 prescription for any medication in the World Health Organization Anatomical Therapeutic Chemical (ATC) main groups or subgroups before diagnosis/matching.

Results: The IBD population had a universally increased use of medications compared with the matched population before IBD diagnosis. At 10 years before diagnosis, the proportion of users was 1.1-fold to 1.8-fold higher in the IBD population in 12 of 14 ATC main groups of medication ( P -value < 0.0001). This applied across age, sex, and IBD subtypes, although it was the most pronounced for Crohn's disease (CD). Two years before diagnosis, the IBD population had a steep increase in medication use for several organ systems. When analyzing therapeutic subgroups of medication, the CD population exhibited 2.7, 2.3, 1.9, and 1.9 times more users of immunosuppressants, antianemic preparations, analgesics, and psycholeptics, respectively, than the matched population 10 years before diagnosis ( P -value < 0.0001).
Original languageEnglish
JournalThe American Journal of Gastroenterology
Issue number12
Pages (from-to)2220-2229
Number of pages10
Publication statusPublished - 1 Dec 2023

Bibliographical note

Copyright © 2023 by The American College of Gastroenterology.


  • Analgesics/therapeutic use
  • Colitis, Ulcerative/drug therapy
  • Crohn Disease/diagnosis
  • Humans
  • Immunosuppressive Agents/therapeutic use
  • Inflammatory Bowel Diseases/diagnosis
  • Prescription Drugs
  • epidemiology
  • Crohn's disease
  • ulcerative colitis
  • prediagnosis
  • pharmacoepidemiology


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