P417 Ulcerative colitis: let’s talk about extent
A. Vaz*, M. Eusébio, A. Antunes, P. Queirós, T. Gago, T. Belo, P. Caldeira, H. Guerreiro
Centro Hospitalar do Algarve, Faro, Portugal
Ulcerative colitis (UC) is a chronic inflammatory disease in which clinical course varies substantially between patients. The extent of the disease is usually pointed out as one of the factors responsible for this variation. With this study, we pretended to evaluate the differences in natural history and pharmacological therapy prescription between left-sided and extended UC.
Retrospective cohort study including patients diagnosed with UC within our department since 2000 and with at least 1-year of follow-up.
In total, 108 patients were included, 54.6% males, with a mean age at diagnosis of 37.7 ± 16 years. At diagnosis, 63 patients (58.3%) presented with left-sided UC, and 45 patients (41.7%) with extensive UC. In 4 patients (3.7%), there was progression from left-sided to extensive UC. Regarding the natural history of the disease, there were no statistical differences in the total number of crisis, severe crisis, or corticosteroid cycles between the 2 types of UC. However, the total number of crisis was slightly superior in patients with left-sided colitis. Regarding immunomodulators, there was a significantly greater prescription in patients with extensive UC (40% vs 22%; p < 0.05). There was no statistical difference in time, number of crisis or corticosteroid cycles until the prescription of immunomodulators, although all of these were also superior in left-sided UC. As for biologics, they were equally administered in both groups (10.1% vs 13.3%), but the time until prescription was significantly lower in extensive UC patients (6.25 vs 1.93 years; p < 0.05).
In this study, we did not find significant differences between the clinical course of left-sided and extensive UC. However, a more conservative therapeutic attitude seems to exist in left-sided ulcerative colitis, which may explain the tendency for the higher number of crisis observed.