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P668 Medical therapy, surgery and hospitalisation rates during the 2- and 3-year follow-up of the 2011 ECCO-EpiCom cohort

Z. Vegh*1, J. Burisch2, I. Kaimakliotis3, D. Duricova4, K. Carlsen2, K. R. Nielsen5, D. K. Christodoulou6, L. Lakatos7, S. Odes8, R. D’Incà9, G. Kiudelis10, S. Turcan11, F. Magro12, 13, 14, A. Goldis15, V. Hernandez16, S. Bell17, E. Langholz18, P. Munkholm2, P. Lakatos1

1Semmelweis University, First Department of Medicine, Budapest, Hungary, 2North Zealand Hospital, University of Copenhagen, Gastro Unit, Medical Section, Copenhagen, Denmark, 3Nicosia private practice, Nicosia private practice, Nicosia, Cyprus, 4Charles University, IBD Centre ISCARE, Prague, Czech Republic, 5The National Hospital of the Faroe Islands, Medical Department, Torshavn, Faroe Islands, 6Faculty of Medicine, University of Ioannina, First Division of Internal Medicine and Division of Gastroenterology, Ioannina, Greece, 7Csolnoky F. Province Hospital, Department of Medicine, Veszprem, Hungary, 8Soroka Medical Centre and Ben-Gurion University of the Negev, Department of Gastroenterology and Hepatology, Beer Sheva, Israel, 9Università di Padova, U. O. Gastroenterologia, Azienda Ospedaliera, Padova, Italy, 10Lithuanian University of Health Sciences, Institute for Digestive Research, Kaunas, Lithuania, 11State University of Medicine and Pharmacy, Department of Gastroenterology, Chisinau, Moldova, Republic of, 12Hospital de São João, Department of Gastroenterology, Porto, Portugal, 13Oporto Medical School, Department of Pharmacology and Therapeutics, Porto, Portugal, 14University of Porto, 8 MedInUP - Centre for Drug Discovery and Innovative Medicines, Porto, Portugal, 15University of Medicine ‘Victor Babes’, Clinic of Gastroenterology, Timisoara, Romania, 16Complexo Hospitalario Universitario de Vigo, Gastroenterology Department, Vigo, Spain, 17St Vincent’s Hospital, Department of Gastroenterology, Melbourne, Victoria, Australia, 18Herlev and Gentofte Hospital, Department C, Gastroenterology Section, Hellerup, Denmark

Background

The ECCO-EpiCom study investigates the differences in the incidence, disease characteristics, and therapeutic strategy of inflammatory bowel diseases (IBD) between Eastern and Western Europe. Our aim was to analyse differences in the 2-and 3-year outcomes between Eastern Europe and Western Europe/Australia in the 2011 ECCO-EpiCom cohort.

Methods

In the study, 8 Western European, 5 Eastern European and 1 Australian Centre participated in the 2- and 3-year follow-up. Patients’ data on medical therapy, surgery, and hospitalisations were registered in the web-based ECCO-EpiCom database.

Results

In total, 319 IBD patients (Crohn’s disease (CD): 126, ulcerative colitis (UC): 160, IBD unclassified: 33; 234 patients from Western Europe/Australia and 85 patients from Eastern Europe; median age at diagnosis: 38.2 years (range: 15.1–88.6); F/M: 137/182) have completed the 2-year and 269 IBD patients completed the 3-year follow-up. During the 2- and 3-year follow-up period, 24 (67%) and 24 (75%) CD patients from Eastern Europe and 54 (60%) and 56 (68%) from Western Europe/Australia received IS (immunosuppressives) (p = NS). 5 (14%) and 5 (16%) CD patients from Eastern Europe and 27 (30%) and 29 (35%) from Western Europe/Australia received biological therapy (p2-year = 0.06 and p3-year = 0.04). Nine (25%) and 9 (28%) CD patients from Eastern Europe and 9 (10%) and 9 (11%) CD patients from Western Europe/Australia underwent surgery (p2-year = 0.03 and p3-year = 0.02). Twelve (33%) and 12 (38%) CD patients from Eastern Europe and 26 (29%) and 28 (34%) from Western Europe/Australia were hospitalised (p2-year = 0.62 and p3-year = 0.70). During the 2- and 3-year follow-up period, about a third of the UC patients received IS in both Eastern Europe and Western Europe/Australia 3-year follow-up: Eastern Europe: 12 (39%) Western Europe/Australia: 33 (34%) p = NS. No difference was found in biological use, surgery and hospitalisation rates in UC patients both during the 2-and 3-year follow-up period (biological therapy: 3-year follow-up: Eastern Europe: 4 (13%), Western Europe/Australia: 15 (16%) p = 0.72; colectomy: 3-year follow-up: Eastern Europe: 1 (3%) Western Europe/Australia: 5 (5%) p = 0.66; hospitalisation: 3-year follow-up: Eastern Europe: 9 (29%) Western Europe/Australia: 33 (34%) p = NS).

Conclusion

At 2 and 3 years after diagnosis, the biological use in CD patients was higher in Western Europe/Australian Centres compared with Eastern Europe. The surgery rate was lower in the former, whereas IS use and hospitalisation rates were not different. In UC, IS, and biological use, colectomy and hospitalisation rates remained similar between these regions.