P787 Clinical and epidemiological features of ulcerative colitis patients in Sardinia, Italy: Results from a multicentre study

G. Mocci1, M. Demurtas2, F.M. Onidi1, M. Picchio3, W. Elisei4, R. Manca5, F. Miculan2, C. Mais2, P. Usai6, F. Chicco6, M.A. Lai6, S. Magrì6, L. Binaghi1, M.F. Dore1, M.P. Dore7, B.Q. Colosso7, L. Cugia8, M. Carta8, R. Pisanu8, M. Marzo9, M.L. Porcedda10, M. Argiolas10, F. Cabras1, A. Armuzzi11

1Brotzu Hospital, Gastroenterology Unit, Cagliari, Italy, 2San Martino Hospital, Digestive Endoscopy, Oristano, Italy, 3’P. Colombo’ Hospital, General Surgery, Velletri, Italy, 4San Camillo Forlanini Hospital, Gastroenterology Unit, Rome, Italy, 5Santissima Trinita Hospital, Gastroenterology Unit, Cagliari, Italy, 6Policlinico Universitario, Gastroenterology Unit, Cagliari, Italy, 7Università, Clinica Medica, Sassari, Italy, 8Santissima Annunziata Hospital, Gastroenterology Unit, Sassari, Italy, 9Cardinale Panico Hospital, Medicine, Tricase, Italy, 10NS Bonaria Hospital, Endoscopy, San Gavino, Italy, 11Presidio Columbus Fondazione Policlinico Universitario A. Gemelli IRCCS- Università Cattolica del Sacro Cuore, IBD Unit, Rome, Italy

Background

There are few data on epidemiological and clinical features of adult ulcerative colitis (UC) patients in the different Italian regions, mainly derived from administrative sources such as Hospital Discharge Register. The aim of this study was to assess the main clinical and epidemiological features of adult patients diagnosed with ulcerative colitis (UC) in Sardinia, Italy.

Methods

We evaluated the main clinical features of UC patients followed-up in 7 Gastroenterology/Endoscopy Units in Sardinia, Italy. Data were obtained from medical patients’ records and from a questionnaire administered at inclusion visit.

Results

442 patients with UC were included: 52.3% were female, with a female-to-male ratio of about 1.1. 10.9% of patients were active smokers and 36.2% were former smokers. Median age at diagnosis was 39 years (IQR 20). 4.5% of patients were <16 years old at diagnosis; 52.7% were diagnosed at age ranging from 17 to 40 and 42.7% at age >40. About three quarters of patients were diagnosed between 17 and 49 years old (23.2% between 17 and 29, 25.5% between 30 and 39 and 23.2% between 40 and 49). Disease extent at diagnosis was proctitis in 18.3% of patients, left-sided colitis in 40.3% and extensive colitis in 39.8%. After a median disease duration of 8 years (IQR 13.8), proximal extension of proctitis or left-sided colitis (from E1 to E2/E3 or from E2 to E3) occurred in 12% of patients. 16.3% of patients developed extraintestinal manifestations, the most frequent being articular (10.6%). There were six patients (1.4%) with concomitant primary sclerosing cholangitis. Two patients developed colorectal cancer. Patient-reported vaccination rates were 30.3% for hepatitis B, 2% for HPV and 1.6% for pneumococcus. The most common therapy was mesalazine: 85.4% of patients were taking it at baseline. 9% of patients were taking corticosteroids, either systemic or with low bioavailability, while 51.7% were exposed to one or more courses of steroids during their disease course. Azathioprine was used by 9.2% of patients; 15.8% withdrew it during their disease course, mainly for adverse events. Overall, 95 patients (21.5%) were exposed to one or more biologic agents: 72 patients (75.8%) were exposed to one biologic agent, 17 (17.9%) to two biologic agents and 6 (6.3%) to three biologic agents. At the study inclusion, 12.4% of patients were under treatment with infliximab, 2.7% with adalimumab, 1.1% with golimumab, and 2.3% with vedolizumab. 3.4% of patients underwent surgery.

Conclusion

In a real-world clinical context, this multicentre study provides important clinical data on UC in Sardinia. Overall, disease phenotype and treatment characteristics were not significantly different from that reported in the other Italian and European cohorts