Ulcerative colitis in northern Portugal and Galicia in Spain

• Published in: Inflammatory bowel diseases 2010-07, Vol.16 (7), p.1227-1238
• Main Authors: Barreiro‐de Acosta, Manuel, Magro, Fernando, Carpio, Daniel, Lago, Paula, Echarri, Ana, Cotter, José, Pereira, Santos, Gonçalves, Raquel, Lorenzo, Aurelio, Carvalho, Laura, Castro, Javier, Barros, Luisa, Dias, Jorge Amil, Rodrigues, Susana, Portela, Francisco, Dias, Camila, da Costa‐Pereira, Altamiro
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; biologic treatment; clinical activity; Colitis, Ulcerative - diagnosis; Colitis, Ulcerative - epidemiology; Colitis, Ulcerative - therapy; Cross-Sectional Studies; Female; Follow-Up Studies; Humans; immunosuppression; Immunosuppressive Agents - therapeutic use; Incidence; Male; Montreal Classification; Portugal - epidemiology; Portugal, Galicia; predictive factors; Prognosis; Risk Factors; southern Europe; Spain - epidemiology; ulcerative colitis; Young Adult
• ISSN: 1078-0998; 1536-4844
• DOI: 10.1002/ibd.21170

Background: Clinical and therapeutic patterns of ulcerative colitis (UC) are variable in different world regions. The purpose of this study was to examine two close independent southern European UC populations from 2 bordering countries and observe how demographic and clinical characteristics of patients can influence the severity of UC. Methods: A cross‐sectional study was conducted during a 15‐month period (September 2005 to December 2006) based on data of 2 Web registries of UC patients. Patients were stratified according to the Montreal Classification and disease severity was defined by the type of treatment taken. Results: A total of 1549 UC patients were included, 1008 (65%) from northern Portugal and 541 (35%) from Galicia (northwest Spain). A female predominance (57%) was observed in Portuguese patients (P < 0.001). The median age at diagnosis was 35 years and median years of disease was 7. The majority of patients (53%) were treated only with mesalamine, while 15% had taken immunosuppressant drugs, and 3% biologic treatment. Most patients in both groups were not at risk for aggressive therapy. Extensive colitis was a predictive risk factor for immunosuppression in northern Portugal and Galicia (odds ratio [OR] 2.737, 95% confidence interval [CI]: 1.846–4.058; OR 5.799, 95% CI: 3.433–9.795, respectively) and biologic treatment in Galicia (OR 6.329, 95% CI: 2.641–15.166). Younger patients presented a severe course at onset with more frequent use of immunosuppressors in both countries. Conclusions: In a large population of UC patients from two independent southern European countries, most patients did not require aggressive therapy, but extensive colitis was a clear risk factor for more severe disease. (Inflamm Bowel Dis 2010)