A Multicentre Study of the Clinical and Epidemiological Profile of Inflammatory Bowel Disease in Northeast Brazil

Abstract

Purpose

Ulcerative colitis (UC) and Crohn’s disease (CD) are inflammatory bowel diseases (IBDs) with multifactorial causes. They are becoming more prevalent in developing countries such as Brazil; however, relevant studies in poorer regions of the country are limited. Here, we report the clinical–epidemiological profile of patients with IBD treated at reference centers in three states of Northeast Brazil.

Patients and Methods

This was a prospective cohort study involving patients at referral outpatient clinics for IBD from January 2020 through December 2021.

Results

Of 571 patients with IBD, 355 (62%) had UC, and 216 (38%) had CD. The patients were predominantly women (355, 62%) for both UC and CD. Extensive colitis was the pattern present in 39% of the UC cases. For CD, ileocolonic disease was the predominant manifestation (38%), with 67% of cases showing penetrating and/or stenosing behavior. The majority of patients were diagnosed between the ages of 17 and 40, corresponding to 60.2% in CD and 52.7% in UC. The median time between symptom onset and diagnosis was 12 months for CD and 8 months for UC (p=0.042). Joint involvement was the most frequent extraintestinal manifestation, with arthralgia and arthritis present in 41.9% and 18.6% of the patients, respectively. Biological therapy was prescribed to 73% of CD patients and 26% of UC patients. A progressive increase in new cases was observed in every 5-year interval over the last five decades, with 58.6% being diagnosed in the last 10 years.

Conclusion

More extensive disease behavior patterns predominated in UC, while forms associated with complications were prevalent in CD. A prolonged time to diagnosis may have contributed to these findings. A progressive increase in IBD incidence was observed and may be related to greater urbanization and better access to specialized outpatient clinics, resulting in improvements in diagnosis.

Keywords:

• inflammatory bowel disease
• ulcerative colitis
• Crohn’s disease
• epidemiology

Data Sharing Statement

All data generated or analyzed during this study are included in the published article.

Ethics Approval and Consent to Participate

Written informed consent for publication was obtained from the patients before information was collected. The patients also provided written consent for the inclusion of personal and clinical details in this study. The study was approved by the Research Ethics Committee of the Centre of Medical Sciences, Federal University of Pernambuco (CAAE [certificate of presentation of ethical appreciation]: 31047320.7.0000.5208).

Consent for Publication

The patients provided written, informed consent for the inclusion of personal and clinical details in this study.

Acknowledgments

We thank the Autoimmune Institute for Research and Continuing Education for its support in the development of this project.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

Dr Lívia Medeiros Soares Celani reports grants from Takeda Pharmaceutical Company, during the conduct of the study. The authors report no other conflicts of interest in this work.

Additional information

Funding

This study was funded by Takeda Pharmaceuticals, Brazil, under a specific grant (IISR-2020-102789). The sponsors did not participate in the design of the study, the analysis of the results, or the content of the publication.