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P141 Presence of anaemia is an indicator of long-term disease course in Inflammatory Bowel Diseases. Results from a population-based inception cohort

P. Lakatos*1, P.A. Golovics1, Z. Vegh1, B. Lovasz1, I. Szita2, M. Balogh3, S. Vavricka4, G. Rogler4, L. Lakatos2

1Semmelweis University, 1st Department of Medicine, Budapest, Hungary, 2Csolnoky F. Province Hospital, Department of Medicine, Veszprem, Hungary, 3Grof Eszterhazy Hospital, Department of Medicine, Papa, Hungary, 4University Hospital Zurich, Department of Internal Medicine, Division of Gastroenterology and Hepatology, Zurich, Switzerland

Background

Anaemia is an important extraintestinal manifestation in inflammatory bowel disease (IBD) and it is partly associated to disease activity. Limited data are available on the association between different forms of anaemia and disease outcomes. The aim of this study was to analyze the association between the prevalence of different forms of anaemia and treatment strategy and long-term disease outcomes in the population-based IBD inception cohort from Veszprem province between 1977 and 2012.

Methods

Data of 506 incident CD patients (male/female: 251/255, age at diagnosis: 31.5 years, SD 13.8 years) and 347 incident UC patients (m/f: 200/147, median age at diagnosis: 36, IQR: 26-50 years) diagnosed between January 1, 1977 and December 31, 2010 were analyzed. Both in- and outpatient records were collected and comprehensively reviewed.

Results

Anaemia (iron deficiency, anaemia of chronic diseases or macrocytic anaemia) was present in 57.5% and 30.2% of CD and UC patients. Anaemia was associated to age at onset (pCD=0.001, pUC=0.026), location/extent (pCD=0.016, pUC<0.001), perianal fistulas (p<0.001) and complicated behavior (p=0.002)/time to behavior change (pLogRank<0.001). In contrast, there was no association with gender and smoking status in either CD or UC. Need for steroids and/or azathioprine was significantly associated to anaemia in both CD and UC (p<0.001 for all both univariate and logistic regression). In addition, anaemia was associated with the need for anti TNF (p=0.002), time to azathioprine (pLogRank<0.001, pCox <0.001), need for (p<0.001) and time to surgery (pLogRank<0.001, pCox <0.001) and time to IBD-related hospitalization (p<0.001) in CD.

 

ECCOJC jju027 P141 F0001

“Figure 1. Association between the presence of anaemia and respective surgery in CD”

In UC, anaemia, was associated with the need for colectomy (p=0.004, OR: 5.57, 95%CI: 1.67–18.54) and time to IBD-related hospitalization (p<0.001, pCox <0.001).

 

ECCOJC jju027 P141 F0002

“Figure 2. Association between presence of anaemia and need for hospitalizations in UC”

 

 

Conclusion

Anaemia is an indicator of long-term disease course, including treatment steps, hospitalizations and surgery requirements in both CD and UC.