Real-World Epidemiology of Inflammatory Bowel Disease in Italy: Treatment Patterns, Adherence, and Costs in Patients with Ulcerative Colitis Treated with Mesalazine.

Authors

Luca Degli Esposti, Chiara Veronesi, Silvia Calabria, Lisa Giannessi, Antonietta Barbieri, Fausto Bartolini, Stefania Dell'Orco, Fulvio Ferrante, Stefano Grego, Cataldo Procacci, Cristina Bezzio, Alessandro Armuzzi

Published in

Drugs - real world outcomes. Oct 12, 2026. Epub Oct 12, 2026.

Abstract

Ulcerative colitis (UC) and Crohn's disease (CD) are chronic immune-mediated conditions associated with a substantial clinical and economic burden. Italian epidemiological evidence is limited. Mesalazine remains a cornerstone of UC management. This study aimed to provide updated epidemiological estimates of inflammatory bowel disease (IBD) in Italy, and to evaluate real-world treatment patterns, adherence to oral mesalazine, and healthcare costs among patients with UC initiating mesalazine therapy.
A retrospective observational analysis was conducted using Italian administrative databases covering ~4 million beneficiaries. Patients with UC and CD were identified (January 2010-May 2023) using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) or exemption codes. Patients with UC who were new users of mesalazine were characterized at baseline. Mesalazine treatment patterns, adherence, and direct healthcare costs were described at follow-up.
At the end of 2023, UC and CD prevalence rates were 272 (95% confidence interval [CI] 267-278) and 166/100,000 (95% CI 162-170) inhabitants, respectively. Incidence rates in 2023 of UC and CD were 18.9 (95% CI 18-20) and 10.8/100,000 (95% CI 10-12), respectively. Among 2552 patients with UC who were new mesalazine users, 69.6% of time-dependent mesalazine users were adherent (versus 56.1% pH-dependent users). Mean annual cost per patients with UC who were new mesalazine users in 2023 was €4516, mainly driven by hospitalizations.
This real-world analysis provides recent epidemiological estimates of UC and CD, and describes a substantial economic burden, highlighting the need for improving adherence and therapeutic pathways.

PMID:
42862468
Bibliographic data and abstract were imported from PubMed on 13 Oct 2026.

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