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* = Presenting author

P667 The clinical features of patients with newly diagnosed moderate-to-severe ulcerative colitis in Korea: a population-based inception cohort study (the MOSAIK cohort)

C. K. Lee*1, S. N. Hong2, J. P. Im3, B. D. Ye4, J. M. Cha1, S.-A. Jung5, K.-M. Lee6, D. I. Park2, Y. T. Jeen7, Y. S. Park8, H. J. Kim1, Y. J. Kim9, T. O. Kim10, G. S. Seo11, E. S. Kim12, J. S. Koo7, J. S. Kim3, B. I. Jang13, J. E. Shin14, J. W. Kim15, Y. S. Park16, J. H. Cheon17, Y. S. Kim18, H. S. Kim19, J. Lee20, J. J. Park17, G. A. Song21, C. S. Eun22, S. J. Shin23, K. C. Huh24, H.-S. Kim25, C. H. Choi26, H. S. Kim27, Y. Kim27

1Kyung Hee University School of Medicine, Internal Medicine, Seoul, South Korea, 2Sungkyunkwan University School of Medicine, Seoul, South Korea, 3Seoul National University College of Medicine and Liver Research Institute, Seoul, South Korea, 4University of Ulsan College of Medicine, Seoul, South Korea, 5Ewha Woman’s University School of Medicine, Seoul, South Korea, 6The Catholic University of Korea College of Medicine, Seoul, South Korea, 7Korea University College of Medicine, Seoul, South Korea, 8Eulji University College of Medicine, Eulji hospital, Seoul, South Korea, 9Gachon University Gil Medical Centre, Incheon, South Korea, 10Inje University College of Medicine, Busan, South Korea, 11Wonkwang University School of Medicine, Iksan, South Korea, 12Keimyung University School of Medicine, Daegu, South Korea, 13Yeungnam University College of Medicine, Daegu, South Korea, 14Dankook University College of Medicine, Cheonan, South Korea, 15Seoul National University Boramae Hospital, Seoul, South Korea, 16Seoul National University Bundang Hospital, Bundang, South Korea, 17Yonsei University College of Medicine, Seoul, South Korea, 18Inje University College of Medicine, Seoul, South Korea, 19Chonnam National University Medical School, Gwangju, South Korea, 20Chosun University College of Medicine, Gwangju, South Korea, 21Pusan National University School of Medicine and Biomedical Research Institute, Busan, South Korea, 22Hanyang University Guri Hospital, Guri, South Korea, 23Ajou University School of Medicine, Suwon, South Korea, 24Konyang University College of Medicine, Daejeon, South Korea, 25Yonsei University Wonju College of Medicine, Wonju, South Korea, 26Chung-Ang University College of Medicine, Seoul, South Korea, 27Janssen Korea, Medical affairs, Seoul, South Korea

Background

There are limited data regarding a disease course of newly diagnosed moderate-to-severe ulcerative colitis (UC) in the Asian population. This nationwide hospital inception cohort study in Korea is aimed to reveal the clinical course of patients with newly diagnosed moderate-to-severe ulcerative colitis for 5-year follow-up under usual care. We report our first interim analysis regarding the baseline features of the patients who were enrolled during the first year of study.

Methods

We have prospectively enrolled patients with newly diagnosed moderate-to-severe UC at 30 tertiary referral hospitals in Korea since 2014, and collected clinical, epidemiologic, and patient-reported outcomes data regarding health-related quality of life. Patients with indeterminate colitis, prior history of colonic resection, or those who participated in interventional clinical trials for UC therapy were excluded. All completed data were transferred via the web to a central database. This study was registered on ClinicalTrials.gov (NCT02229344).

Results

Of 131 patients enrolled, 128 who met eligibility criteria were analysed. Of these, 67.2% (86/128) were male, with a male to female ratio of 2.0. The median of age was 34.5 years (14–77); the peak age of onset of symptoms was 20–29 years (28.1%). Further, 5 patients (4.2%) had a first-degree family history of inflammatory bowel disease (exclusively UC), and 1 patient (0.7%) had a history of appendectomy. The disease extent was 12.7% for E1, 39.7% for E2, and 47.6% for E3 according to the Montreal classification. Systemic corticosteroids as an initial treatment were used for 46.1% (59/128) of patients, and their uses were associated with the disease extent (18.8% for E1, 32.0% for E2, and 63.3% for E3, p < 0.001) and the disease activity (43.1% for moderate and 75.0% for severe activity, p = 0.03). With respect to patient-reported outcomes, a high percentage of overall work impairment (48.5%) and daily activity impairment (48.6%) were observed. In addition, a substantial number of patients had clinically significant mood disorder (defined as %score > 11 of the Hospital Anxiety and Depression Scale): anxiety for 11.0% and depression for 13.3%. A clinically significant depression was more common in patients aged over 40 than in younger patients (23.6% vs 5.5%, p = 0.01).

Conclusion

The first interim analysis of the MOSAIK cohort shows a male predominance, a peak occurrence in the third decade, and a high proportion of left-sided and extensive colitis. Our data suggest that both assessment of psychosocial distress and adequate psychological support should be integrated into an initial management plan for patients with newly diagnosed moderate-to-severe UC.