P423 Epidemiology, diagnostic work-up and pharmacological requirements of inflammatory bowel disease (IBD) in Spain: Results from the nationwide EpidemIBD study of GETECCU. (16th January 2018) - Chaparro, M
Abstract: Background: To assess the incidence of inflammatory bowel disease (IBD) in Spain, to describe the characteristics of patients at diagnosis, to evaluate the need for immunomodulators (IMM) or biologics, and to assess the time from the onset of symptoms to the diagnosis of the disease. Methods: Prospective and population-based nationwide study in Spain. Adult patients diagnosed with IBD -Crohn's disease (CD), ulcerative colitis (UC), or indeterminate colitis (IC) during 2017 in the 17 Spanish regions have been included and followed up for 12 months after diagnosis. Data were captured in a web-based database (AEG-REDCap). Results: Up to October 31, 2017, 2, 404 patients from 122 centres covering ~50% of the Spanish population have been included: 53% males, mean age 40 years, 25% smokers. Among patients, 49% had UC, 46% CD, and 5% IC. About 15% of them had a family history of IBD. The mean time from symptoms onset to IBD diagnosis was 3 months (range 0–198). At the time of diagnosis, 8.6% of the patients had extra-intestinal manifestations (the most frequent were rheumatologic disorders, in 6% of the cases). In CD patients, 53% had ileal location, 20% colonic, 27% ileocolonic, 3% upper gastrointestinal tract involvement, and 11% perianal disease; 11% of patients had stenosing and 7% fistulising behaviour at the time of diagnosis. In UC patients, 36% had extensive colitis and 30% left-sided colitis at diagnosis. For the diagnosis work-up, 98% of patients underwent colonoscopy; among CD patients, 32% underwent MRI-enterography, 31% CT-scan, 13% upper endoscopy, 11% exploration under anaesthesia, 4.6% capsule-endoscopy, 4% perianal MRI and 3% small-bowel follow-through. Current median follow-up is 6 months. Median age was higher in UC than in CD patients (44 vs. 39 years, p < 0.01), and median time from symptoms onset to diagnosis was significantly longer in CD than in UC (4 vs. 2 months, p < 0.01). Demographic characteristics at diagnosis of CD and UC are summarised in Table 1. Conclusions: Up to 20% of CD patients showed an aggressive clinical phenotype – stenosing or fistulising –at diagnosis. The pharmacological requirements and the use of diagnostic resources were high in IBD patients, and were higher in CD than in CU patients.