PhD Scientific Days 2022

Clinical Medicine V. (Poster discussion will take place in the Aula during the Coffee Break)

Epidemiology, treatment strategy, natural disease course and surgical outcomes of patients with ulcerative colitis in Western Hungary – a population-based study between 2007 and 2018, data from the Veszprem County cohort

Text of the abstract

Background:
The number of prospective population-based studies evaluating the epidemiology of
ulcerative colitis (UC) are still limited from Eastern Europe.
Aim:
Our aim was to analyze the incidence and disease phenotype at diagnosis, treatment strategy, disease course and colectomy rates in a prospective population-based database including incident UC patients diagnosed between 2007 and 2018. The present study is a continuation of the Veszprem IBD cohort with a follow-up of the incidence and disease course of IBD since 1977.
Methods:
Data of 467 incident UC patients were analyzed (male/female: 236/231; median age at
diagnosis: 36 years(y) IQR: 25-54). Both in-hospital and outpatient records were collected
and comprehensively reviewed at diagnosis and during clinical follow-up. The mean length
of follow-up was 8.34y. Probability of medium-, long-term change in disease course and
surgical outcomes were analyzed using Kaplan–Meier survival analysis.
Results:
Adjusted mean incidence rate was 11.02 /10 5 person-years in this 12 year period. Prevalence
rate was 283.51/10 5 persons in 2011 and 317.79 in 2015. Disease extension was proctitis in
22.3%, left sided colitis in 43.9%, and extensive colitis in 33.8% of the patients at diagnosis.
The probability of disease progression into more extensive phenotype was 6.9% at 3 years,
8.3% at 5 years and 11.3% at 10 years. Distribution of maximal therapeutic steps during the
course of follow-up were 5-ASA in 46.9%, systemic corticosteroids in 16.3%, immunosuppressive therapy in 19.3%; anti-TNF biologic therapy in 12.2% and other biologic therapy in 4.3%. The probability of receiving biological therapy after diagnosis was 9.9% at 3 years, 13.9% at 5 years and 17.8% at 10 years in this cohort. The probability of colectomy was 1.5% at 1 year, 3.6% at 5 years and 4.4% at 10 years in Kaplan-Meier analysis.
Conclusions:
The incidence of UC in this period was high, similar to high-incidence areas in Western
Europe and to our previous data from the Veszprem cohort. Disease extension at diagnosis,
distribution of highest treatment step and the probability of disease proximal extension was
comparable to other European population-based data. Medium- and long-term colectomy
rates were lower compared to Western European centers, but somewhat higher than our
previous data from the Veszprem cohort (2002-2006).
Funding:
ÚNKP-21-4-II-SE-31