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The following is a summary of “A Trend Analysis of Inflammatory Bowel Disease in Non-Endemic Era (1993-2023),” published in the January 2024 issue of Gastroenterology by Çagir et al.

Researchers launched a retrospective study to track the evolving demographics and epidemiology of Ulcerative Colitis (UC) and Crohn’s Disease (CD) within a non-endemic era for inflammatory bowel disease (IBD) over the past three decades.

They assessed UC and CD patients with follow-up periods of at least six months (June 1993 and February 2023). Electronic medical records, individual inquiries, and IBD registries were utilized to gather data on all patients’ clinical and demographic features.

The results showed 1549 adult patients with UC and CD. UC was diagnosed in 873 (56.4%) patients (male 538, 61.6%), while CD was diagnosed in 676 (43.6%) patients (male 404, 59.8%). The median follow-up duration was 8.3 years for UC patients, with 6.8 years for CD patients. Among UC patients, proctitis was observed in 154 (17.6%), left-sided colitis in 410 (47%), and extensive colitis in 309 (35.4%) cases. In CD patients, ileal involvement was present in 297 (43.9%), colonic in 76 (11.2%), ileocolonic in 299 (44.2%), and isolated upper GI involvement in 4 cases(0.6%). Regarding behavior, 529 (78.3%) CD patients had non-stenotic non-penetrating behavior, 45 (6.7%) had stenosis behavior, and 102 (15.1%) had penetrating behavior, with 196 (29%) patients having perianal disease. Mesalazine (75.4%) and thiopurine (45.5%) were the most commonly used conventional treatments for UC, while thiopurine (45%) was most frequently used for CD patients. Over the last two decades, the proportion of biologic usage was 27.9% and 32.1% in UC patients and 28.5% and 31.4% in CD patients, respectively. Abdominal surgery rates were 49.2%, 27.8%, and 36.3% in CD patients over three decades, while colectomy rates were 2.0%, 2.7%, and 3.7% in UC patients. The rate of UC patients slightly decreased to 98 (61.6%), 401 (58.5%), and 374 (53%), while the frequency of CD patients increased to 61 (38.4%), 284 (41.5%), and 331 (47%) over three decades. Despite having more UC patients than CD patients over the three decades, the proportion of UC/CD continuously decreased (1.61, 1.41, and 1.13), respectively.

They concluded that in a non-endemic IBD era, UC diagnoses plateaued while CD rose, yet surgery rates stayed stable despite increased biologics use.

Source: academic.oup.com/ecco-jcc/article/18/Supplement_1/i743/7585965