Characterization of inflammatory bowel disease in Colombia: Results of a national register

Abstract

Aim: To determine the clinical, sociodemographic, and treatment characteristics of inflammatory bowel disease (IBD) in a Colombian population register. Methods: A descriptive, analytic, observational, cross-sectional, multicenter study on patients with IBD from 17 hospital centers in 9 Colombian cities was conducted. Results: A total of 2,291 patients with IBD were documented, 1,813 (79.1%) of whom presented with ulcerative colitis (UC), 456 (19.9%) with Crohn's disease (CD), and 22 with IBD unclassified (0.9%). The UC/CD ratio was 3.9:1. A total of 18.5% of the patients with UC and 47.3% with CD received biologic therapy. Patients with extensive UC had greater biologic therapy use (OR = 2.78, 95% CI: 2.10-3.65, p = 0.000), a higher surgery rate (OR = 5.4, 95% CI: 3.5-8.3, p = 0.000), and greater frequency of hospitalization (OR = 4.34, 95% CI: 3.47-5.44, p = 0.000). Patients with severe UC had greater biologic therapy use (OR = 5.04, 95% CI: 3.75-6.78, p = 0.000), a higher surgery rate (OR = 8.64, 95% CI: 5.4-13.78, p = 0.000), and greater frequency of hospitalization (OR = 28.45, 95% CI: 19.9-40.7, p = 0.000). CD patients with inflammatory disease behavior (B1) presented with a lower frequency of hospitalization (OR = 0.12, 95% CI: 0.07-0.19, p = 0.000), a lower surgery rate (OR = 0.08, 95% CI: 0.043-0.15, p = 0.000), and less biologic therapy use (OR = 0.26, 95% CI: 0.17-0.41, p = 0.000). Conclusion: In Colombia, there is a predominance of UC over CD (3.9:1), as occurs in other Latin American countries. Patients with extensive UC, severe UC, or CD with noninflammatory disease behavior (B2, B3) have a worse prognosis. Resumen: Objetivo: Determinar las características clínicas, sociodemográficas y tratamiento de la EII en un registro de la población colombiana. Metodología: Estudio observacional descriptivo, analítico, multicéntrico, de corte transversal de una cohorte nacional de pacientes con EII en 17 centros de nueve ciudades del país. Resultados: Se documentaron 2,291 pacientes con EII, 1,813 (79.1%) con CU, 456 (19.9%) con EC y 22 con EII no clasificable (0.9%). La razón CU/EC es de 3.9:1. 18.5% de los pacientes con CU y 47.3% con EC han recibido terapia biológica. Los pacientes con CU extensa presentaban mayor uso de terapia biológica (OR = 2.78; IC 95%: 2.10-3.65; P = 0.000), mayor tasa de cirugía (OR = 5.4; IC 95%: 3.5-8.3; P = 0.000) y mayor frecuencia de hospitalización (OR = 4.34; IC 95%: 3.47-5.44; P: 0.000). Los pacientes con CU severa presentaban mayor uso de terapia biológica (OR = 5.04; IC 95%: 3.75-6.78; P = 0.000), mayor tasa de cirugía (OR = 8.64; IC 95%: 5.4-13.78; P = 0.000) y mayor frecuencia de hospitalización (OR = 28.45; IC 95%: 19.9-40.7; P = 0.000). Los pacientes con EC inflamatorio (B1) presentaban menor frecuencia de hospitalización (OR = 0.12; IC 95%: 0.07-0.19; P = 0.000), menor tasa de cirugía (OR = 0.08; IC 95%: 0.043-0.15; P: 0.000) y menor uso de terapia biológica (OR = 0.26; IC 95%: 0.17-0.41; P: 0.000). Conclusión: En nuestro país existe un predominio de CU sobre EC (3.9:1), como ocurre en otros países de Latinoamérica. Los pacientes con CU extensa y severa y con EC de comportamiento no inflamatorio (B2, B3) tienen peor pronóstico.

Keywords

• Enfermedad inflamatoria intestinal
• Colitis ulcerativa
• Enfermedad de Crohn