Search

Summary: Background: Cohort studies comparing the characteristics of childhood‐onset and adulthood‐onset inflammatory bowel disease (IBD) in the biologics era are scarce. Aim: To compare disease characteristics, the use of immunomodulators and biologic agents and the need for surgery between childhood‐ and adulthood‐onset IBD. Methods: Inflammatory bowel disease patients from the ENEIDA registry diagnosed between 2007 and 2017 were included. The childhood‐onset cohort comprised patients diagnosed at ≤16 years of age and the adulthood‐onset cohort those diagnosed at >16 years. The cumulative incidences of immunosuppressive therapy, biologic therapy and surgery were estimated using Kaplan‐Meier curves, compared by the log‐rank test. Cox regression analysis was performed to identify potential predictive factors of treatment with immunosuppressants, biologic agents or surgery. Results: The adulthood‐onset cohort comprised 21 200 patients out of 20 354 (96%) and the childhood‐onset cohort 846 (4%). Median follow‐up was 54 months in the childhood‐onset cohort and 38 months in the adulthood‐onset cohort (P < 0.01). Proportions of Crohn's disease, ileocolonic involvement and inflammatory behaviour at diagnosis were higher in the childhood‐onset cohort. In the multivariate analysis, after adjusting for sex, type of IBD, extraintestinal manifestations, family history and smoking habit, childhood‐onset IBD was associated with higher risk of immunomodulator use (hazard ratio [HR] = 1.2, 95% confidence interval [95% CI] = 1.1‐1.2) and higher probability of receiving biologic treatment (HR = 1.2, 95% CI = 1.1‐1.3). However, childhood‐onset IBD was not associated with higher risk of surgery (HR = 0.9, 95% CI = 0.8‐1.2). Conclusions: Childhood‐onset IBD has differential characteristics and higher risk of treatment with immunomodulators and biologic agents, compared with adulthood‐onset IBD. Nevertheless, paediatric IBD is not associated with higher risk of surgery. [ABSTRACT FROM AUTHOR]

Background: Inflammatory bowel disease (IBD) is associated with a considerable burden to the patient and society. However, current data on IBD incidence and burden are limited because of the paucity of nationwide epidemiological studies, heterogeneous designs, and a low number of participating centers and sample size. The EpidemIBD study is a large-scale investigation to provide an accurate assessment of the incidence of IBD in Spain, as well as treatment patterns and outcomes. Methods: This multicenter, population-based incidence cohort study included patients aged >18 years with IBD (Crohn's disease, ulcerative colitis, or unclassified IBD) diagnosed during 2017 in 108 hospitals in Spain, covering 50% of the Spanish population. Each participating patient will attend 10 clinic visits during 5 years of follow up. Demographic data, IBD characteristics and family history, complications, treatments, surgeries, and hospital admissions will be recorded. Results: The EpidemIBD study is the first large-scale nationwide study to investigate the incidence of IBD in Spain. Enrollment is now completed and 3627 patients are currently being followed up. Conclusions: The study has been designed to overcome many of the limitations of previous European studies into IBD incidence by prospectively recruiting a large number of patients from all regions of Spain. In addition to epidemiological information about the burden of IBD, the 5-year follow-up period will also provide information on treatment patterns, and the natural history and financial burden of IBD. [ABSTRACT FROM AUTHOR]