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Vol. 46. Issue 2.
Pages 102-108 (February 2023)
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Vol. 46. Issue 2.
Pages 102-108 (February 2023)
Original article
Incidence, and natural history of inflammatory bowel disease in Castilla y León:Prospective and multicenter epidemiological study
Incidencia e historia natural de la enfermedad inflamatoria intestinal en Castilla y León: estudio prospectivo, multicéntrico y poblacional
Rosa María Sáiz-Chumillasa, Jesús Barriob, Luis Fernández-Salazarc, Lara Ariasa, Mónica Sierra Ausínd, Concepción Piñeroe, Ana Fuentes Coronelf, Laura Matag, Mónica Vásqueza, Ana Carbajob, Noelia Alcaidec, Noelia Canod, Aejandro Nuñeze, Paola Fradejasf, Mercedes Ibáñezg, Luis Hernándezh, Beatriz Siciliaa,
Corresponding author
bsicilia4@gmail.com

Corresponding author.
a Hospital Universitario de Burgos, Burgos, Spain
b Hospital Universitario Río Hortega, Valladolid, Spain
c Hospital Clínico Universitario de Valladolid, Valladolid, Spain
d Complejo Asistencial Universitario de León, León, Spain
e Hospital Universitario de Salamanca, Salamanca, Spain
f Hospital Virgen de la Concha de Zamora, Zamora, Spain
g Hospital de Medina del Campo, Valladolid, Spain
h Hospital Santos Reyes de Aranda de Duero, Burgos, Spain
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Abstract
Introduction

The incidence of Inflammatory Bowel Disease (IBD) is increasing worldwide.

Objectives

To evaluate the incidence of IBD in Castilla y León describing clinical characteristics of the patients at diagnosis, the type of treatment received and their clinical course during the first year.

Materials and methods

Prospective, multicenter and population-based incidence cohort study. Patients aged>18 years diagnosed during 2017 with IBD (Crohn’s disease [CD], ulcerative colitis [UC] and indeterminate colitis [IC]) were included from 8 hospitals in Castilla y León. Epidemiological, clinical, and therapeutic variables were registered. The global incidence and disease incidence were calculated.

Results

290 patients were diagnosed with IBD (54.5% UC, 45.2% CD, and 0.3% IC), with a median follow-up of 9 months (range 8-11). The incidence rate of IBD in Castilla y Leon in 2017 was 16.6 cases per 10.000 inhabitants-year (9/105 UC cases and 7.5/105 CD cases), with a UC/CD ratio of 1.2:1. Use of systemic corticosteroids (47% vs. 30% p=0.002), immunomodulatory therapy (81% vs. 19%; p=0.000), biological therapy (29% vs. 8%; p=0.000), and surgery (11% vs. 2%; p=0.000) were significatively higher among patients with CD comparing with those with UC.

Conclusions

The incidence of patients with UC in our population increases while the incidence of patients with CD remains stable. Patients with CD presents a worse natural history of the disease (use of corticosteroids, immunomodulatory therapy, biological therapy and surgery) compared to patients with UC in the first year of follow-up.

Keywords:
Incidence
Inflammatory bowel disease
Crohn’s disease
Ulcerative colitis
Natural history
Treatment
Resumen
Introducción

La incidencia de la enfermedad inflamatoria intestinal (EII) está aumentando en todo el mundo.

Objetivos

Evaluar la incidencia de EII en la Comunidad Autónoma de Castilla y León y describir las características clínicas de los pacientes al diagnóstico, el tipo de tratamiento recibido y la evolución clínica durante el primer año.

Material y métodos

Estudio prospectivo, multicéntrico y poblacional en el que se incluyeron pacientes adultos diagnosticados de EII (enfermedad de Crohn [EC], colitis ulcerosa [CU] o colitis indeterminada [CI] durante el año 2017 procedentes de 8 centros de Castilla y León. Se incluyeron variables epidemiológicas, clínicas y terapéuticas. Se calculó la incidencia global y por enfermedades.

Resultados

Doscientos noeventa pacientes fueron diagnosticados de EII (54,5% de CU, 45.2% de EC y 0,3% de CI), con una mediana de seguimiento de 9 meses (rango 8–11). La tasa de incidencia fue de 16.6 casos/100.000 habitantes-año (9/105 casos de CU y 7.5/105 casos de EC), con una proporción CU/EC de 1,2:1. Los pacientes con EC recibieron significativamente más corticoides sistémicos (47% vs. 30% p=0.002), más tratamiento inmunomodulador (81% vs. 19% p=0.000), más tratamiento biológico (29% vs. 8% p=0.000) y mayor necesidad de cirugía (11% vs. 2% p=0.000).

Conclusiones

La incidencia de pacientes con CU en nuestro medio se incrementa mientras que la de EC se mantiene estable, con una historia natural de la enfermedad peor (uso de corticoides, inmunosupresores, biológicos y cirugía) para los pacientes con EC comparado con los pacientes con CU en el primer año de seguimiento.

Palabras clave:
Incidencia
Enfermedad inflamatoria intestinal
Enfermedad de Crohn
Colitis ulcerosa
Historia natural
Tratamiento

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