P663 Long-term follow up in IBD: 10-year observational study of a UK IBD cohort.
Radhakrishnan, S.T.(1,2);Vasireddy, A.(3);Gallagher, K.I.(1);Hicks, L.C.(1,2); Powles, S.T.(1,4);Chong, L.(1,5);Peake, S.T.(2);Orchard, T.R.(2);Williams, H.R.T.(1,2);
(1)Imperial College London, Department of Digestion Metabolism and Reproduction, London, United Kingdom;(2)Imperial College Healthcare NHS Trust, Department of Gastroenterology, London, United Kingdom;(3)London North West University Healthcare NHS Trust, Acute Medicine, London, United Kingdom;(4)Chelsea and Westminster NHS foundation Trust, Department of Gastroenterology, London, United Kingdom;(5)Guy's and St Thomas' NHS Foundation Trust, Department of Gastroenterology, London, United Kingdom
Background
Crohn’s Disease (CD) and ulcerative colitis (UC) are the two main sub-types of Inflammatory Bowel disease (IBD), which affect 300-500 per 100,000 people within Europe, with an increasing incidence. Long-term outcomes have been reported cohorts of Korean and Scandinavian populations, but long-term UK data are limited.
Methods
Data were prospectively collected from an IBD cohort over a 10-year period. 90 patients were included (47 CD, 36 UC, 7 IBD-unclassified). Phenotypic data (Montreal classification), medication and management decisions were documented. Statistical significance was determined by the Z-score for 2 population proportions.
Results
Over 10 years, the number of operations for CD significantly increased from 8 to 19 patients (p=0.03) but not significantly in UC from 1 to 4 (p=0.09). Perianal involvement in CD also increased from 15.5% to 27.7% at 10 years, but this change was non-significant (p=0.14). Within the UC cohort, a trend for aminosalicylate use was seen, increasing from 53% to 64% (p=0.34), whilst thiopurine use decreased from 44% to 28% (p=0.12). 6/36 patients with UC and 10/47 patients with CD failed thiopurine use due to intolerance or severe side-effects. Biologic use in both UC and CD significantly increased from 10 to 22 patients (p=0.013) over 10 years.
Conclusion
This is the first long-term observational study in IBD patients within the UK. The data show that even with an increase in biologic availability and prescribing, the overall lifetime risk of surgical management in CD does increase with time, mirroring recent publications. Studies with an increased number of IBD patients under long-term follow up are ongoing.