P173 Comparison of clinical outcomes between young and adult-onset ulcerative colitis: a multicentre KASID study
S.-K. Park*1, J. Y. Kim2, D. S. Han3, K.-C. Huh4, C. K. Lee5, J. E. Shin6, J. H. Kim7, Y. S. Kim8, Y. Jung9, S.-A. Jung10, H. J. Song11, H. J. Jang12, D. I. Park1
1Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea, 2Kangbuk Samsung Hospital, Seoul, South Korea, 3Hanyang University Guri Hospital, Guri, South Korea, 4Konyang University, Daejeon, South Korea, 5Kyung Hee University, Seoul, South Korea, 6Dankook University, Chonan, South Korea, 7Dongguk University, Goyang, South Korea, 8Inje University, Seoul, South Korea, 9Soonchunhyang University, Chonan, South Korea, 10Ewha Woman’s University, Seoul, South Korea, 11Jeju National University, Jeju, South Korea, 12Hallym University, Seoul, South Korea
The aim of this study was to compare the clinical features and disease outcomes of ulcerative colitis (UC) according to the age of onset in Korea.
We enrolled 1 141 patients diagnosed with UC between July 1987 and November 2013 at 11 tertiary hospitals. We retrospectively reviewed and compared the baseline characteristic and disease state at onset, and treatment during the disease course amongst the young-onset (YO < 20years) and adult-onset (AO ≥ 20years) patients. Severe outcome was defined as use of IV steroids, infliximab, immunosuppressant, or UC-related operation.
There were 55 YO (mean age 17.8 ± 2.4; male 52.7%) and 1 086 AO patients (mean age 43.0 ± 13.6; male 56.7%). In the YO group, smoking and body mass index (BMI) ≥ 23 kg/m2 were less frequent than in the AO (5.6% vs 25.3%, p = 0.000; 12.7% vs 41.1%, p = 0.000, respectively). Mayo score (7.7 ± 3.0 vs 5.6 ± 2.7, p = 0.000) was more higher and extensive UC (52.7% vs 25.8%, p = 0.000) was more frequent in the YO than in the AO group. There were no differences in UC-related admission, operation or oral steroid use. IV steroid (41.8% vs 18.0%, p = 0.000), immunosuppressant (47.3% vs 26.9%, p = 0.002), and infliximab (20.0% vs 7.2%, p = 0.001) use were more common in the YO than in the AO group. In the multivariate analysis, severe outcome was related to YO (HR 2.18, 95%CI 1.27–3.71, p = 0.040), lower body mass index (BMI) (HR 1.46, 95%CI 1.07–2.00, p = 0.018), severe (HR 2.29, 95%CI 1.36–3.38, p = 0.002) and moderate (HR 2.48, 95%CI 1.67–3.67, p = 0.000) disease, extensive UC (HR 2.90, 95% CI 1.79–4.69, p = 0.000), UC-related admission (HR 63.89, 95%CI 20.41–200.02, p = 0.000), and oral steroid use (HR 0.51, 95%CI 0.39–0.67, p = 0.000).
UC with YO presented with more advanced clinical features at onset and more severe outcome compared with the AO. Careful management and intense treatment strategies should be considered for YO patients.