P262 Influence of a positive family history on the clinical course of inflammatory bowel disease
S. W. Hwang*1, M. S. Kwak1, W. S. Kim1, J.-M. Lee1, S. H. Park1, H.-S. Lee1, D.-H. Yang1, K.-J. Kim1, B. D. Ye1, J.-S. Byeon1, S.-J. Myung1, Y. S. Yoon2, C. S. Yu2, J.-H. Kim1, S.-K. Yang1
1University of Ulsan College of Medicine, Asan Medical Centre, Department of Gastroenterology, Seoul, South Korea, 2University of Ulsan College of Medicine, Asan Medical Centre, Department of Colon and Rectal Surgery, Seoul, South Korea
Previous studies on the difference in phenotypes and disease course between familial and sporadic inflammatory bowel disease (IBD) have been controversial, although family history was considered to increase the risk of developing IBD.
The influence of family history on phenotypes and disease course of IBD was analysed in 2 805 Korean patients with Crohn’s disease (CD), and 3 266 with ulcerative colitis (UC). Familial IBD was defined as the existence of one or more first-, second- and/or third-degree relatives affected with CD or UC.
A positive family history of IBD was noted in 191 (6.8%) patients with CD and 212 (6.5%) patients with UC. In patients with CD, the rate of anti-TNF use was significantly higher in familial cases than in sporadic cases (p < 0.05). When analysed after excluding patients who underwent intestinal resection within 1 year of diagnosis, the cumulative probability of intestinal resection was significantly higher in familial cases (p = 0.007). In multivariate analysis, family history was an independent risk factor for the time to first intestinal resection in patients with CD (hazard ratio, 1.61, 95% confidence interval, 1.13–2.29, p = 0.009). In patients with UC, younger age at diagnosis and more females were observed in familial cases (p < 0.001).
The present study suggests the possibility of a more aggressive clinical course of CD in familial compared with sporadic cases. However, a population-based approach is needed to evaluate appropriately the influences of family history on the clinical course of IBD.