S1064 A Longitudinal Evaluation of Patients With Inflammatory Bowel Disease in Puerto Rico

Abstract

Introduction: A high prevalence of inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), has been reported among Hispanics; however, its characterization is scarce. We aim to describe changes in clinical outcomes following the disease course for at least 3 years in a cohort from Puerto Rico (PR). Methods: The UPR IBD Registry has collected clinical data on patients since 1995. We used a longitudinal survey tool to assess demographic and medical information of patients with IBD with a minimum 3-year follow-up. Subjects were first interviewed between 2012-2018, and the longitudinal component throughout 2020-2022. We analyzed sociodemographic, food security, body mass index (BMI), hospitalizations and surgeries, family history, and medications. Intellectus statistics was used for data analysis. The study was approved by the MSC-IRB. Results: 91 subjects were recruited, 50.6% (45/91) were male, and 72.5% (66/91) had a CD diagnosis. Two subjects initially diagnosed with UC were later re-diagnosed with CD [74.7% (68/91)]. The majority were single (60%), mean age was 35+15 years initially and 39+16 years for the later survey. The most-reported level of education was a bachelor's degree (41%). The mean BMI in the longitudinal survey (27+6 kg/m2) was significantly higher than in the original questionnaire (25+6 kg/m2) [p< 0.001]. We found no difference between household income between timepoints; these ranged between $28K to $29K annually. 76% had hospitalizations in the original survey and 29% in the longitudinal questionnaire. 43% of participants reported undergoing surgery in the initial questionnaire, and 28% of the subjects during follow-up [p< 0.001]. We observed a decreasing trend in the following medications: aminosalicylates, corticosteroids, immunomodulators, and antibiotics. We observed increased use of integrin blockers and IL 12/23 antagonists. 27.5% of participants reported therapeutic failure in the longitudinal survey. Conclusion: We observed a significant increase in BMI and targeted therapies after a minimum of three years of follow-up with a concomitant decrease in recent hospitalizations, conventional medications, and reported surgeries. Even though an increase in IBD diagnosis has been observed in Puerto Rico, better clinical outcomes have resulted over the last few years. A longer follow-up period with a larger sample is needed to better evaluate outcomes in this special population. Table 1. - For Longitudinal Variables Variable Original Questionnaire n (%)n=91 Longitudinal Questionnaire n (%)n=91 p-value IBD Diagnosis Crohn's Disease 66 (72.5) 68 (74.7) < 0.001 Ulcerative Colitis 25 (27.5) 23 (25.3) Food Security Category Very-Low Food Security - 1 (1.10) n/a Low Food Security - 17 (18.7) Marginal Food Security - 34 (37.4) High Food Security - 37 (40.7) BMI by Category Underweight 10 (11) 7 (7.7) < 0.001 Normal 34 (37.4) 37 (40.7) Overweight 17 (18.7) 23 (25.3) Obese 17 (18.7) 24 (26.4) IBD Medication Aminosalicylates 66 (72.5) 23 (25.3) 0.003 Corticosteroids 65 (71.4) 28 (30.8) 0.891 Immunomodulators 34 (37.4) 22 (24.2) 0.041 Antibiotics 38 (41.8) 10 (11) 0.310 Anti-TNF 54 (59.3) 51 (56) < 0.001 Integrin blockers 5 (5.5) 16 (17.6) 0.003 Interleukin antagonists 5 (5.5) 23 (25.3) 0.013 Note. Due to rounding errors, percentages may not equal 100%.