A Multicentre Study of the Clinical and Epidemiological Profile of Inflammatory Bowel Disease in Northeast Brazil.

Autor: de Brito CAA; Department of Gastroenterology, Hospital das Clínicas, Federal University of Pernambuco, Recife, Pernambuco, Brazil.; Department of Gastroenterology, Member of the Brazilian Organization of Crohn's Disease and Colitis - GEDIIB, São Paulo, Brazil.; Department of Internal Medicine, Centre of Medical Sciences of the Federal University of Pernambuco, Recife, Pernambuco, Brazil.; Department of Immunology, Autoimune Research Institute, Recife, Pernambuco, Brazil., Celani LMS; Department of Gastroenterology, Member of the Brazilian Organization of Crohn's Disease and Colitis - GEDIIB, São Paulo, Brazil.; Department of Gastroenterology, Onofre Lopes Hospital, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil., de Araújo MVT; Department of Gastroenterology, Member of the Brazilian Organization of Crohn's Disease and Colitis - GEDIIB, São Paulo, Brazil.; Department of Gastroenterology, Lauro Wanderley Hospital, Federal University of Paraíba, João Pessoa, Paraíba, Brazil., de Lucena MT; Department of Coloproctology, Barão de Lucena Hospital, Recife, Pernambuco, Brazil., Vasconcelos GBS; Department of Gastroenterology, Hospital das Clínicas, Federal University of Pernambuco, Recife, Pernambuco, Brazil.; Department of Gastroenterology, Member of the Brazilian Organization of Crohn's Disease and Colitis - GEDIIB, São Paulo, Brazil.; Department of Gastroenterology, University of Pernambuco, Recife, Pernambuco, Brazil., Lima GAS; Department of Gastroenterology, Hospital das Clínicas, Federal University of Pernambuco, Recife, Pernambuco, Brazil.; Department of Gastroenterology, Member of the Brazilian Organization of Crohn's Disease and Colitis - GEDIIB, São Paulo, Brazil.; Department of Immunology, Autoimune Research Institute, Recife, Pernambuco, Brazil., Nóbrega FJF; Department of Gastroenterology, Member of the Brazilian Organization of Crohn's Disease and Colitis - GEDIIB, São Paulo, Brazil.; Department of Gastroenterology, Lauro Wanderley Hospital, Federal University of Paraíba, João Pessoa, Paraíba, Brazil., Diniz GTN; Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Recife, Brazil., Lucena-Silva N; Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Recife, Brazil., Toneto GT; Department of Immunology, Autoimune Research Institute, Recife, Pernambuco, Brazil., Falcão JVC; Department of Immunology, Autoimune Research Institute, Recife, Pernambuco, Brazil., Barbosa PM; Department of Immunology, Autoimune Research Institute, Recife, Pernambuco, Brazil., de Oliveira PRF; Department of Coloproctology, Barão de Lucena Hospital, Recife, Pernambuco, Brazil., Dantas LSX; Department of Gastroenterology, Onofre Lopes Hospital, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil., Fernandes LKC; Department of Gastroenterology, Lauro Wanderley Hospital, Federal University of Paraíba, João Pessoa, Paraíba, Brazil., de Araújo SA; Department of Gastroenterology, Lauro Wanderley Hospital, Federal University of Paraíba, João Pessoa, Paraíba, Brazil., Martinelli VF; Department of Gastroenterology, Hospital das Clínicas, Federal University of Pernambuco, Recife, Pernambuco, Brazil.; Department of Gastroenterology, Member of the Brazilian Organization of Crohn's Disease and Colitis - GEDIIB, São Paulo, Brazil.; Department of Immunology, Autoimune Research Institute, Recife, Pernambuco, Brazil.
Jazyk: angličtina
Zdroj: Clinical and experimental gastroenterology [Clin Exp Gastroenterol] 2023 Jun 21; Vol. 16, pp. 87-99. Date of Electronic Publication: 2023 Jun 21 (Print Publication: 2023).
DOI: 10.2147/CEG.S411936
Abstrakt: Purpose: Ulcerative colitis (UC) and Crohn's disease (CD) are inflammatory bowel diseases (IBDs) with multifactorial causes. They are becoming more prevalent in developing countries such as Brazil; however, relevant studies in poorer regions of the country are limited. Here, we report the clinical-epidemiological profile of patients with IBD treated at reference centers in three states of Northeast Brazil.
Patients and Methods: This was a prospective cohort study involving patients at referral outpatient clinics for IBD from January 2020 through December 2021.
Results: Of 571 patients with IBD, 355 (62%) had UC, and 216 (38%) had CD. The patients were predominantly women (355, 62%) for both UC and CD. Extensive colitis was the pattern present in 39% of the UC cases. For CD, ileocolonic disease was the predominant manifestation (38%), with 67% of cases showing penetrating and/or stenosing behavior. The majority of patients were diagnosed between the ages of 17 and 40, corresponding to 60.2% in CD and 52.7% in UC. The median time between symptom onset and diagnosis was 12 months for CD and 8 months for UC ( p =0.042). Joint involvement was the most frequent extraintestinal manifestation, with arthralgia and arthritis present in 41.9% and 18.6% of the patients, respectively. Biological therapy was prescribed to 73% of CD patients and 26% of UC patients. A progressive increase in new cases was observed in every 5-year interval over the last five decades, with 58.6% being diagnosed in the last 10 years.
Conclusion: More extensive disease behavior patterns predominated in UC, while forms associated with complications were prevalent in CD. A prolonged time to diagnosis may have contributed to these findings. A progressive increase in IBD incidence was observed and may be related to greater urbanization and better access to specialized outpatient clinics, resulting in improvements in diagnosis.
Competing Interests: Dr Lívia Medeiros Soares Celani reports grants from Takeda Pharmaceutical Company, during the conduct of the study. The authors report no other conflicts of interest in this work.
(© 2023 Brito et al.)
Databáze: MEDLINE