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P603 Paediatric onset inflammatory bowel disease is not associated with more disability compared with adult onset disease

S. Picardo*1, R. Panaccione1, G. Kaplan1,2, C. Seow1,2, J. deBruyn3, Y. Leung1,4

1Univeristy of Calgary, Inflammatory Bowel Disease Unit, Calgary, Canada, 2University of Calgary, Community Health Sciences, Calgary, Canada, 3Univeristy of Calgary, Pediatric Gastroenterology, Calgary, Canada, 4University of British Columbia, Inflammatory Bowel Disease Unit, Vancouver, Canada

Background

A diagnosis of inflammatory bowel disease (IBD) during the paediatric years, may result in a larger burden of disability given that disease onset is coinciding with critical periods for physical and psychosocial development. The Inflammatory Bowel Disease Disability Index (IBD-DI) has recently been developed and validated to assess disability in patients with IBD. Our aims were to assess the burden of disability in paediatric onset as compared with adult onset disease using this index.

Methods

The IBD-DI was administered to a cohort of adult patients with either paediatric or adult onset IBD, matched by duration of disease at the University of Calgary. Sociodemographic and clinical parameters including measures of disease activity, the Harvey–Bradshaw Index (HBI) for Crohn’s disease (CD) and Partial Mayo Score (PM) for ulcerative colitis (UC), were collected from participants as well as database review. A quantitative IBD-DI score was computed, based on a previously validated method.1 IBD-DI scores were compared between groups and bivariate analysis of variance was used to identify factors associated with disability level.

Results

200 patients (101 paediatric onset, 99 adult onset) were recruited. The distributions in IBD-DI scores did not differ significantly between adult onset and paediatric onset disease (25.18 ± 13.98 vs. 22.16 ± 13.91, p = 0.13) (Figure 1)

Figure 1. Distribution in Inflammatory Bowel Disease Disability Index (IBD-DI) scores between paediatric and adult onset IBD.

There were also no significant differences in scores between Crohn’s disease and ulcerative colitis in adult onset (26.14 ± 13.98 vs. 22.62 ± 13.93, p = 0.27) and paediatric onset disease (22.35 ± 13.77 vs. 21.67 ± 14.50, p = 0.83), respectively. Age>25 years (p = 0.02), female gender (p = 0.04), active smokers (p =0.03) and clinically active disease (p < 0.001) were associated with higher IBD-DI scores. IBD-DI scores correlated with measures of disease activity, PM (r = 0.64, p < 0.001) and HBI (r = 0.65, p < 0.001). Patients with paediatric onset disease demonstrated significantly higher negative influencer scores (family, p = 0.04) and lower positive influencer scores (family, p = 0.02 and health professionals, p = 0.03.)

Conclusion

Patients with paediatric onset IBD have a similar burden of disability compared with those with adult onset disease. They however were less likely to view family and health professional’s as facilitators and more likely to view family as a barrier to their disease and disability. Factors associated with higher disability scores include age>25 years, female gender, active smokers and clinically active disease.

Reference

1. Gower-Rousseau C, Sarter H, Savoye G, et al. Validation of the inflammatory bowel disease disability index in a population-based cohort. Gut, 2017;66:588–596.