P861 Frequency and Influence of a Positive Family History on the Clinical Course of Inflammatory Bowel Diseases
Liava, C.(1)*;Sinakos, E.(1);Dimitroulas, T.(1);Navrozidou, C.(2);Akriviadis, E.(1,2);
(1)Aristotle University of Thessaloniki, Fourth Department of Internal Medicine- Hippokration General Hospital of Thessaloniki, Thessaloniki, Greece;(2)Interbalkan Medical Center of Thessaloniki, Gastroenterology Unit, Thessaloniki, Greece;
Previous studies on the difference in phenotypes and disease course between familial and sporadic inflammatory bowel diseases (IBD) have resulted in heterogenous conclusions. However, a positive family history is considered the strongest recognizable risk factor for developing IBD and is present in 8-12% of cases. We aimed to compare the frequency of a positive family history between patients with Crohn’s disease (CD) and ulcerative colitis (UC) and additionally to evaluate possible clinical parameters that may influence the clinical course of familial IBD cases, based on retrospectively-prospectively collected data of a cohort of IBD patients followed in daily clinical practice.
Patients with biopsy-confirmed IBD aged 10–90 years old were included in the study. A comprehensive questionnaire was used to collect data on each site visit from July 2018 to March 2022. Logistic regression analysis was used to examine clinical parameters that may influence the clinical course of familial IBD cases and the chi-squared test to compare the frequency of a positive family history between patients with UC and CD.
We collected 300 patients diagnosed with IBD (180 with CD, 113 with UC, and 7 with indeterminate colitis). About 10% of IBD patients had a first degree relative with IBD (13% in CD and 4% in UC group, P< .05), as summarized in table 1. Female IBD patients had a 4-fold increased risk to have a first degree relative with IBD (OR 3.79; 95% CI: 1.44-9.98; P< .01). Similarly, CD patients had a 3-fold increased risk (OR 3.31; 95% CI: 1.08-10.18); P< .05). IBD patients who had a first degree relative with IBD were at greater risk for hospitalization for IBD flare or other complications (OR 3.07; 95% CI: 1.12-8.38; P< .05), to undergo a surgical procedure, mainly colectomy (OR 5.20; 95% CI: 1.98-13.68; P< .01), to develop perianal disease (OR 3.42; 95% CI: 1.25-9.35; P< .05), to develop sacroiliitis (OR 3.72; 95% CI: 1.40-9.91; P< .01), and to being treated with anti-TNF agents (OR 3.21; 95% CI: 1.14-9.08; P< .05). Furthermore, in patients with a family history of IBD there was a trend for extraintestinal manifestations (OR 2.47; 95% CI: 0.91-6.74; P= .078), especially from the musculoskeletal system (OR 2.45; 95% CI: 0.94-6.34; P= .066), skin (OR 2.83; 95% CI: 0.94-8.45; P= .065) and ocular system (OR 4.92; 95% CI: 0.89-27.26; P= .068), as shown in table 2.
In this retrospective-prospective cohort study, family history of IBD in first degree relatives was present in 13% of patients with CD and 4% of patients with UC, and was associated with increased risk for hospitalization, surgical procedures, occurrence of perianal disease, treatment with anti-TNF agents, and a trend for developing EIMs.