P626. Extraintestinal manifestations in Romanian IBD patients - evaluation of a cohort of over 1000 patients
In Western European IBD cohorts over one third of patients are affected by extraintestinal manifestations/complications. In Romania solid epidemiological data on this topic is still lacking. Taking into account the fact that in our country diagnosis and therapeutic management of patients with IBD is conducted mainly in referral centers we have implemented a web-accessed database to facilitate collection of significant IBD epidemiological data Nationwide (IBDPROSPECT). The aim of our study was to identify phenotypic an epidemiological characteristics of Romanian patients with IBD and extraintestinal manifestations (EM) of disease, based on a large tertiary referral center cohort provided by IBDPROSPECT database.
Epidemiological and phenotypical data from 1217 patients with inflammatory bowel disease were prospectively registered between 2006 and 2013. Complete sets of data for statistical analysis was available for 1022 patients. Statistical analysis was conducted using chi-square test for categorical variables, time data was analysed by log-rank test. P value <0.05 was considered for statistical significance.
Overall extraintestinal manifestations were present in 15.9% of Romanian IBD patients: arthritis in 7.7% of cases, ankylosing spondylitis 3.5%, erythema nodosum in 1.8%, primary sclerosing cholangitis in 1.1%, oftalmological manifestations in 0.9% and pyoderma gangrenosum in 0.4% of patients. Female gender was associated with the presence of EM (60.6%, p = 0.0006), but not smoking habit or age at diagnosis. Overall EM were more frequent encountered in patients with Crohn's disease (CD) and inflammatory bowel disease unclassified (IBD-U) than with ulcerative colitis (UC) (24.3%, 23.3% vs. 9.9%, p < 0.00001). There was a strong correlation between the presence of extraintestinal manifestations and ileocolonic extension of CD (30.4%, p < 0.00001), intestinal fistulas (35.5% p < 0.00001) as well as stenosing pattern of CD (23.4%, p = 0.02) but not with perianal disease. The mean diagnostic delay of IBD in patients with EM was 19.8 months compared to 8.5 months in patients with IBD and no EM (p < 0.00001).
Our data suggests a lower rate of extraintestinal manifestations in Romanian patients with IBD than previously reported for Western cohorts and also some specific phenotypic associations as higher incidence of EM in complicated CD with intestinal fistulas and stenosing behaviour but not with perianal disease.