Abstract
Background
Inflammatory bowel disease (IBD) is currently recognised as a global health problem, since its incidence and prevalence have increased significantly worldwide in recent years. Studies in Latin America are only limited to reporting incidence and prevalence, so our main objective is to report the clinical and epidemiological characteristics of IBD in Latin American and Caribbean countries.
Methods
This is a multicentre cohort study in which 8 Latin American and Caribbean countries were included: Colombia, Cuba, Mexico, Peru, Puerto Rico, Dominican Republic, Uruguay and Venezuela during the period from August 2017 to October 2019. Two study groups were conducted by geographic region due to their ethnicity, Group 1) Caribbean: Cuba, Puerto Rico and Dominican Republic, Group 2) Latin America: Colombia, Mexico, Venezuela and Peru. Statistical analysis was performed with the statistical programme SPSS v.24. A value of p <0.05 was taken as significant.
Results
This study included a total of 4216 IBD patients from 8 countries. The CD was more frequent than UC in the following countries: Puerto Rico with 68.5%, Dominican Republic 56.3% and Peru with 53.1%, while in the rest of the countries the frequency of UC predominated, in Colombia by 79.2%, Venezuela in 78.4%, Cuba in 69.9% and Mexico in 75.8%. The Caribbean countries had a significantly higher frequency in the fistulising phenotype in CD with 65.1% (p = 0.0001), steroid dependence in 11.51% (pp = 0.002), steroid resistance in 28.5% (pp = 0.0001), thiopurine intolerance in 1.40% (p = 0.0002), extraintestinal manifestations in 55.91% (p = 0.0001), IBD surgeries in 32.10% (p = 0.0001) and family history of IBD reported a frequency of 15.60% (p = 0.0001). For Latin America, the frequency of pancolitis was more frequent in 48.21% (p = 0001) in patients with UC. The factors associated with the use of biological therapy were: fistulising phenotype in CD, steroid resistance, thiopurine intolerance, presence of extraintestinal manifestations and IBD-related surgeries. There is an increased frequency in the diagnosis of IBD in the last two decades (2000–2019), being 7.5 times for UC and 12.5 times for CD as show in Figure 1.
Conclusion
This is the first large and multicentre study in Latin America and the Caribbean which showed significant increase in the diagnosis of IBD in the last two decades as well as the differences in clinical and epidemiological characteristics between both regions.
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