OBJECTIVE: To evaluate the incidence of IBD in Castilla y León describing clinical characteristics of the patients at diagnosis, the type of treatment received and their clinical course during the first year.
METHODS: Prospective, multicenter and population-based incidence cohort study. Patients aged >18 years diagnosed during 2017 with IBD (Crohn\'s disease [CD], ulcerative colitis [UC] and indeterminate colitis [IC]) were included from 8 hospitals in Castilla y León. Epidemiological, clinical, and therapeutic variables were registered. The global incidence and disease incidence were calculated.
RESULTS: 290 patients were diagnosed with IBD (54.5% UC, 45.2% CD, and 0.3% IC), with a median follow-up of 9 months (range 8-11). The incidence rate of IBD in Castilla y Leon in 2017 was 16.6 cases per 10,000 inhabitants-year (9/105 UC cases and 7.5/105 CD cases), with a UC/CD ratio of 1.2:1. Use of systemic corticosteroids (47% vs 30%; P=.002), immunomodulatory therapy (81% vs 19%; P=.000), biological therapy (29% vs 8%; P=.000), and surgery (11% vs 2%; p=.000) were significatively higher among patients with CD comparing with those with UC.
CONCLUSIONS: The incidence of patients with UC in our population increases while the incidence of patients with CD remains stable. Patients with CD present a worse natural history of the disease (use of corticosteroids, immunomodulatory therapy, biological therapy and surgery) compared to patients with UC in the first year of follow-up.
目的:评估卡斯蒂利亚莱昂IBD的发病率,描述诊断时患者的临床特征,第一年接受的治疗类型及其临床疗程。
方法:前瞻性,多中心和基于人群的发病率队列研究。2017年诊断为IBD的年龄>18岁的患者(克罗恩病[CD],溃疡性结肠炎[UC]和不确定结肠炎[IC])来自卡斯蒂利亚莱昂的8家医院。流行病学,临床,和治疗变量进行了登记。计算了全球发病率和疾病发病率。
结果:290例患者被诊断为IBD(54.5%UC,45.2%CD,和0.3%IC),中位随访时间为9个月(范围8-11)。2017年卡斯蒂利亚和莱昂的IBD发病率为每10,000居民年16.6例(9/105UC病例和7.5/105CD病例),UC/CD比为1.2:1。使用全身性皮质类固醇(47%vs30%;P=0.002),免疫调节治疗(81%vs19%;P=.000),生物治疗(29%vs8%;P=.000),与UC患者相比,CD患者的手术(11%vs2%;p=.000)明显更高。
结论:我们人群中UC患者的发病率增加,而CD患者的发病率保持稳定。CD患者的自然史较差(使用皮质类固醇,免疫调节治疗,生物治疗和手术)与随访第一年的UC患者相比。