Emerging IBD demographics, phenotype and treatment in South Asia, South-East Asia and Middle East: P

Emerging IBD demographics, phenotype and treatment in South Asia, South-East Asia and Middle East: Preliminary findings from the IBD-Emerging Nations' Consortium

Rupa Banerjee 1, Partha Pal 1, Ida Hilmi 2, Uday C Ghoshal 3, Devendra C Desai 4, M Masudur Rahman 5, Usha Dutta 6, Syed A Mohiuddin 7, Munnera Al Mohannadi 7, Mathew Philip 8, Ganesh N Ramesh 9, Madunil A Niriella 10, Arjuna P De Silva 10, H Janaka de Silva 10, Pises Pisespongsa 11, Julajak Limsrivilai 12, Satimai Aniwan 13, Metthananda Nawarathne 14, Nilesh Fernandopulle 14, Than Than Aye 15, Nwe Ni 16, Sameer Al Awadhi 17, Neeraj Joshi 18, Pham Thi V Ngoc 19, Tuan V Kieu 19, Anh Duong Nguyen 19, Murdani Abdullah 20, Ezzat Ali 21, Ahmed Zeid 21, Jose D Sollano 22, Bismillah Saberi 23, Mahmoud Omar 24, Mostafa Noor Mohsin 25, Hafeza Aftab 5, Tin Moe Wai 26, Yogesh M Shastri 27, Sujit Chaudhuri 28, Faruque Ahmed 5, Shobna J Bhatia 29, Simon P L Travis 30

Published Feb 2022, in the Journal of gastroenterology and Hepatology.


Abstract

Background and aim: Inflammatory bowel disease (IBD) is emerging in the newly industrialized countries of South Asia, South-East Asia, and the Middle East, yet epidemiological data are scarce. Methods: We performed a cross-sectional study of IBD demographics, disease phenotype, and treatment across 38 centers in 15 countries of South Asia, South-East Asia, and Middle East. Intergroup comparisons included gross national income (GNI) per capita. Results: Among 10 400 patients, ulcerative colitis (UC) was twice as common as Crohn's disease (CD), with a male predominance (UC 6678, CD 3495, IBD unclassified 227, and 58% male). Peak age of onset was in the third decade, with a low proportion of elderly-onset IBD (5% age > 60). Familial IBD was rare (5%). The extent of UC was predominantly distal (proctitis/left sided 67%), with most being treated with mesalamine (94%), steroids (54%), or immunomodulators (31%). Ileocolic CD (43%) was the commonest, with low rates of perianal disease (8%) and only 6% smokers. Diagnostic delay for CD was common (median 12 months; interquartile range 5-30). Treatment of CD included mesalamine, steroids, and immunomodulators (61%, 51%, and 56%, respectively), but a fifth received empirical antitubercular therapy. Treatment with biologics was uncommon (4% UC and 13% CD), which increased in countries with higher GNI per capita. Surgery rates were 0.1 (UC) and 2 (CD) per 100 patients per year. Conclusions: The IBD-ENC cohort provides insight into IBD in South-East Asia and the Middle East, but is not yet population based. UC is twice as common as CD, familial disease is uncommon, and rates of surgery are low. Biologic use correlates with per capita GNI.

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