P806 Natural history of Paediatric Black British inflammatory bowel disease

Abstract

There is limited knowledge on the phenotype and outcome of inflammatory bowel disease (IBD) in Black British children. Studies from 2008 in the USA have hinted at possible differences in the age of symptom onset between Caucasians and African-American children with IBD and have found that children of African-American ethnicity tend to have more complicated stricturing and penetrating disease in the Crohn’s population. The aim of this study is to review the clinical picture and outcomes of Black-British children with IBD. The study is a single-centre retrospective cohort study of children aged 0 to 18 years with inflammatory bowel disease diagnosed between January 2005 and June 2017. Data were collected using the electronic patient record system and included demographics, anthropometrics, disease classification using the PARIS criteria and outcome measures including the use of biologic treatment and surgery. A total cohort of 101 patients with IBD were included in the study (Caucasian (C) n = 68, Black British (BB) n = 33). The median age at diagnosis was similar (C 12.67 years vs BB 12.92 years). In the Crohn’s disease population (CD) both groups had similar disease site distribution however the Black British population had an increased incidence of perianal disease (44.4% vs 22.2% in the Caucasian group). The PCDAI score at presentation was similar (C 23.12 vs BB 27). For the ulcerative colitis group the disease classification and severity was also similar in both groups with pancolonic disease being more prevalent. Twenty-six patients with IBD in the Caucasian group compared with 7 patients in the Black British group required biologic treatment but the Black British patients had a shorter time to biologic treatment of 0.558 years compared with 1.52 years in the Caucasian group. The need for surgical intervention was higher in the Black British group with 8 out of 33 patients requiring surgical treatment, compared with 5 patients out of 68 in the Caucasian group. The Black British population required earlier introduction to biologic treatment and had increased need for surgery. This study is limited by its small sample population and currently the authors are working towards increasing the sample population through collaboration with other centres. Prospective multi-centre longitudinal analyses are required to look at the genetic, immunological, social and economic factors that could explain these subtle differences.