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P766 Differences among disease pattern, medication use, surgery and hospitalisation rates in a low prevalence of ulcerative colitis population: A retrospective cohort from Bangkok, Thailand

S. Aniwan*1, J. Limsrivilai2

1Chulalongkorn University, Internal Medicine, Bangkok, Thailand, 2Siriraj Hospital, Internal Medicine, Bangkok, Thailand

Background

The incidence of ulcerative colitis (UC) in Thailand is much lower than in the West. The burden of UC varies in different countries and populations. The aim of this study was to describe a temporal trend in disease characteristics, treatment pattern, disease outcomes after diagnosis in a low prevalence of UC population.

Methods

The medical records of 262 patients who were first diagnosed with UC from 2000 through 2017 in two University hospitals from Bangkok, Thailand were longitudinally reviewed for a total of 2100 person-years with a median follow-up duration of 7.7 years. The cumulative probability of thiopurine use, biologic use, developing IBD-related intestinal surgery and IBD-related hospitalisation was estimated using the 1-Kaplan Meier method. We stratified calendar period of UC diagnosis into 2000–2009 and 2010–2017.

Results

Demographic characteristics of the UC cohort are demonstrated in Table 1.

Table 1. Baseline Characteristic of ulcerative colitis Cohorts, Between 2000 Through 2017.

Patients diagnosed in 2010–2017 were significantly older age at diagnosis and required systemic corticosteroid less than those of patients diagnosed in 2000–2009. The 5-year cumulative probability of thiopurine use of UC patients diagnosed in 2010–2017 were significantly higher than those of UC patients diagnosed in 2000–2009 (39% vs. 63%; p < 0.01, respectively). There were two biologic users in 2000–2009 and none of patient diagnosed in 2010–2017. For UC-related surgery, the cumulative probabilities of surgery after diagnosis among calendar period of 2000–2009 decreased from 5.8% to 1.3% when compared with calendar period of 2010–2017. For UC-related hospitalisation, the cumulative probability of hospitalisation was similar between two calendar periods (Figure 1).

Figure 1. Cumulative probability of thiopurine use (A), surgery (B) and hospitalisation (C) in UC cohort

Conclusion

In this cohort shows the increase in thiopurine users paralleled with the decrease rates of systemic corticosteroid users and surgery. In Thailand, disease severity of UC was comparable to the West. However the rates of surgery and hospitalisation were relatively low as compared with the West.