Frontiers in Medicine (Feb 2022)

Immigrant IBD Patients in Spain Are Younger, Have More Extraintestinal Manifestations and Use More Biologics Than Native Patients

  • Ana Gutiérrez,
  • Ana Gutiérrez,
  • Ana Gutiérrez,
  • Pedro Zapater,
  • Pedro Zapater,
  • Pedro Zapater,
  • Pedro Zapater,
  • Elena Ricart,
  • Elena Ricart,
  • María González-Vivó,
  • Jordi Gordillo,
  • David Olivares,
  • Isabel Vera,
  • Míriam Mañosa,
  • Míriam Mañosa,
  • Javier P. Gisbert,
  • Javier P. Gisbert,
  • Mariam Aguas,
  • Mariam Aguas,
  • Eugenia Sánchez-Rodríguez,
  • Maia Bosca-Watts,
  • Viviana Laredo,
  • Blau Camps,
  • Ignacio Marín-Jiménez,
  • Ignacio Marín-Jiménez,
  • Yamile Zabana,
  • Yamile Zabana,
  • María Dolores Martín-Arranz,
  • Roser Muñoz,
  • Mercè Navarro,
  • Eva Sierra,
  • Lucía Madero,
  • Milagros Vela,
  • José Lázaro Pérez-Calle,
  • Empar Sainz,
  • Xavier Calvet,
  • Xavier Calvet,
  • Lara Arias,
  • Victor Morales,
  • Fernando Bermejo,
  • Fernando Bermejo,
  • Luis Fernández-Salazar,
  • Manuel Van Domselaar,
  • Luisa De Castro,
  • Cristina Rodríguez,
  • Carmen Muñoz-Villafranca,
  • Rufo Lorente,
  • Montserrat Rivero,
  • Eva Iglesias,
  • Eva Iglesias,
  • Belén Herreros,
  • David Busquets,
  • Joan Riera,
  • María Pilar Martínez-Montiel,
  • Marta Roldón,
  • Oscar Roncero,
  • Esther Hinojosa,
  • Mónica Sierra,
  • Jesús Barrio,
  • Ruth De Francisco,
  • José Huguet,
  • Olga Merino,
  • Daniel Carpio,
  • Daniel Ginard,
  • Fernando Muñoz,
  • Marta Piqueras,
  • Pedro Almela,
  • Federico Argüelles-Arias,
  • Guillermo Alcaín,
  • Luis Bujanda,
  • Luis Bujanda,
  • Luis Bujanda,
  • Noemí Manceñido,
  • Alfredo J. Lucendo,
  • Alfredo J. Lucendo,
  • Pilar Varela,
  • Iago Rodríguez-Lago,
  • Iago Rodríguez-Lago,
  • Laura Ramos,
  • Laura Sempere,
  • Laura Sempere,
  • Eva Sesé,
  • Manuel Barreiro-de Acosta,
  • Eugeni Domènech,
  • Eugeni Domènech,
  • Rubén Francés,
  • Rubén Francés,
  • Rubén Francés,
  • Rubén Francés

DOI
https://doi.org/10.3389/fmed.2022.823900
Journal volume & issue
Vol. 9

Abstract

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BackgroundPrevious studies comparing immigrant ethnic groups and native patients with IBD have yielded clinical and phenotypic differences. To date, no study has focused on the immigrant IBD population in Spain.MethodsProspective, observational, multicenter study comparing cohorts of IBD patients from ENEIDA-registry who were born outside Spain with a cohort of native patients.ResultsWe included 13,524 patients (1,864 immigrant and 11,660 native). The immigrants were younger (45 ± 12 vs. 54 ± 16 years, p < 0.001), had been diagnosed younger (31 ± 12 vs. 36 ± 15 years, p < 0.001), and had a shorter disease duration (14 ± 7 vs. 18 ± 8 years, p < 0.001) than native patients. Family history of IBD (9 vs. 14%, p < 0.001) and smoking (30 vs. 40%, p < 0.001) were more frequent among native patients. The most prevalent ethnic groups among immigrants were Caucasian (41.5%), followed by Latin American (30.8%), Arab (18.3%), and Asian (6.7%). Extraintestinal manifestations, mainly musculoskeletal affections, were more frequent in immigrants (19 vs. 11%, p < 0.001). Use of biologics, mainly anti-TNF, was greater in immigrants (36 vs. 29%, p < 0.001). The risk of having extraintestinal manifestations [OR: 2.23 (1.92–2.58, p < 0.001)] and using biologics [OR: 1.13 (1.0–1.26, p = 0.042)] was independently associated with immigrant status in the multivariate analyses.ConclusionsCompared with native-born patients, first-generation-immigrant IBD patients in Spain were younger at disease onset and showed an increased risk of having extraintestinal manifestations and using biologics. Our study suggests a featured phenotype of immigrant IBD patients in Spain, and constitutes a new landmark in the epidemiological characterization of immigrant IBD populations in Southern Europe.

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