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P166. Predictive factors for anatomic extent of lesions in patients affected by ulcerative colitis

E. Lolli, P. Scarozza, A. Bella, S. Onali, G. Condino, F. Zorzi, M. Ascolani, C. Petruzziello, L. Biancone, F. Pallone, E. Calabrese, Gastroenterology Unit, University of Rome Tor Vergata, Department of Systems Medicine, Rome, Italy

Background

Disease extent in ulcerative colitis (UC) represents a variable parameter over time. Aim of our retrospective study was to identify predictive factors for anatomic extent of lesions in pts affected by UC.

Methods

A total of 832 pts affected by UC under regular follow up were retrospectively considered. Four hundred seventy pts [250 M (53%); median age 46 years, range 18–88] were included in the final analysis and divided into two groups: extending anatomic lesion group (cases; n = 136; 29%) and stable lesion group (controls; n = 334; 71%). Bivariate analysis was conducted to identify possible association with UC extent. Logistic regression was performed using Chi-squared test for quantitative dichotomic variables and Student's t-test for continuous variables.

Results

Among 470 UC pts, 15% (n = 59) had familial history of IBD, 32.5% (n = 117) were ex smokers and 5% (n = 26) of pts presented extra-intestinal manifestations. At diagnosis time, 35% (n = 165) of pts had distal UC, while 65% (n = 305) had left UC; 31% (n = 144) of pts needed steroid therapy at diagnosis while 96% (n = 440) was treated with 5-ASA. During disease course, 19.5% (n = 92) of pts was treated with immunosuppressants (ISS), and 10% of pts (n = 46) with biologics. A dysplastic lesion or colorectal cancer was diagnosed in 7% of pts (n = 33). Regression logistic analysis demonstrated that independent predictive factors for anatomic extent of lesions were the presence of proctitis at diagnosis (OR = 3.04, CI 2–4.6, p < 0.0001), the presence of extra-intestinal manifestations (OR = 2.21, CI 0.99–4.91, p = 0.05), moderate or severe relapses (OR = 2.98, CI 1.56–5.68, p = 0.001) and high number of relapses during disease course (OR = 1.1, CI 1.05–1.15, p = 0.0001). Biologic and ISS therapy was higher in the case group (OR 3.39, CI 2.11–5.44; p = 0.0001 for ISS; OR 2.75, CI 1.48–5.09; p = 0.001 for biologics). Otherwise smoking habit did not result a protective factor for anatomic extent of lesions in UC.

Conclusion

Our study showed that proctitis, extra-intestinal manifestations at diagnosis, moderate/severe and high number of relapses, are associated with anatomic extent of lesions in UC over time, leading the physician to a tight clinical and endoscopic monitoring of these specific subsets of pts.