Influence of familial forms of inflammatory bowel disease on the use of immunosuppressants, biological agents, and surgery in the era of biological therapies. Results from the ENEIDA project
Por:
González-Muñoza, C, Calafat, M, Gisbert, JP, Iglesias, E, Minguez, M, Sicilia, B, Aceituno, M, Gomollón, F, Calvet, X, Ricart, E, De Castro, L, Rivero, M, Mesonero, F, Márquez, L, Nos, P, Rodriguez-Pescador, A, Guardiola, J, García-Sepulcre, M, García-López, S, Lorente-Poyatos, RH, Alba, C, Sánchez-Ocaña, R, Vera, I, Madero, L, Riestra, S, Navarro-Llavat, M, Pérez-Calle, JL, Camps, B, Van Domselaar, M, Lucendo, AJ, Martin-Arranz, MD, Montoro-Huguet, MA, Sierra-Ausin, M, Llao, J, Carpio, D, Varela, P, Merino, O, Fernandez-Salazar, L, Piqueras, M, Sese, E, Busquets, D, Tardillo, C, Maroto, N, Riera, J, Martinez-Flores, C, Munoz, F, Gordillo-abalos, J, Bertoletti, F, Garcia-Planella, E and Domènech, E
Publicada:
24 jun 2024
Ahead of Print:
1 jun 2024
Resumen:
Background and aims Familial inflammatory bowel disease (IBD) history is a controversial prognostic factor in IBD. We aimed to evaluate the impact of a familial history of IBD on the use of medical and surgical treatments in the biological era.Methods Patients included in the prospectively maintained ENEIDA database and diagnosed with IBD after 2005 were included. Familial forms were defined as those cases with at least one first-degree relative diagnosed with IBD. Disease phenotype, the use of biological agents, or surgical treatments were the main outcomes.Results A total of 5263 patients [2627 Crohn's disease (CD); 2636 ulcerative colitis (UC)] were included, with a median follow-up of 31 months. Of these, 507 (10%) corresponded to familial forms. No clinical differences were observed between familial and sporadic IBD forms except a lower age at IBD diagnosis and a higher rate of males in familial forms of UC. In CD, the proportions of patients treated with thiopurines (54.4% vs 46.7%; P = .015) and survival time free of thiopurines (P = .009) were lower in familial forms. No differences were found regarding the use of biological agents. Concerning surgery, a higher rate of intestinal resections was observed in sporadic CD (14.8% vs 9.9%, P = .027). No differences were observed in UC.Conclusions In the era of biological therapies, familial and sporadic forms of IBD show similar phenotypes and are managed medically in a similar way; whether these is due to lack of phenotypical differences or an effect of biological therapies is uncertain. What is already known on this topic: IBD's etiopathogenesis points to an interaction between environmental and genetic factors, being familial history a controversial prognostic factor. Biological agents use and need for surgery regarding familial or sporadic forms of IBDs present conflicting results. What this study adds: Familial and sporadic forms of IBD have similar phenotypes and are managed medically and surgically in a similar way. How this study might affect research, practice or policy: Familial aggregation should not be considered a factor associated with more aggressive disease.Conclusions In the era of biological therapies, familial and sporadic forms of IBD show similar phenotypes and are managed medically in a similar way; whether these is due to lack of phenotypical differences or an effect of biological therapies is uncertain. What is already known on this topic: IBD's etiopathogenesis points to an interaction between environmental and genetic factors, being familial history a controversial prognostic factor. Biological agents use and need for surgery regarding familial or sporadic forms of IBDs present conflicting results. What this study adds: Familial and sporadic forms of IBD have similar phenotypes and are managed medically and surgically in a similar way. How this study might affect research, practice or policy: Familial aggregation should not be considered a factor associated with more aggressive disease.
Filiaciones:
González-Muñoza, C:
Hosp Santa Creu & Sant Pau, Gastroenterol Dept, Barcelona, Spain
Univ Autonoma Barcelona, Dept Med, Barcelona, Spain
:
Hosp Badalona Germans Trias & Pujol, Gastroenterol Dept, Badalona, Spain
Gisbert, JP:
Hosp Princesa, Gastroenterol Dept, Madrid, Spain
Univ Autonoma Madrid UAM, Madrid, Spain
Iglesias, E:
Hosp Univ Reina Sofia, Gastroenterol Dept, Cordoba, Spain
Minguez, M:
Hosp Clin Valencia, Gastroenterol Dept, Valencia, Spain
Sicilia, B:
Hosp Univ Burgos, Dept Gastroenterol, Burgos, Spain
Aceituno, M:
Hosp Univ Mutua Terrassa, Gastroenterol Dept, Terrassa, Spain
Gomollón, F:
Hosp Clin Univ Lozano Blesa, Gastroenterol Dept, Zaragoza, Spain
Calvet, X:
Hosp Parc Tauli, Gastroenterol Dept, Sabadell, Spain
Ricart, E:
Hosp Clin Barcelona, Gastroenterol Dept, Barcelona, Spain
De Castro, L:
Hosp Alvaro Cunqueiro, Gastroenterol Dept, Vigo, Spain
IMIM Barcelona, Barcelona, Spain
Rivero, M:
Hosp Marques Valdecilla, Santander, Spain
Mesonero, F:
Hops Univ Ramon Y Cajal, Gastroenterol Dept, Madrid, Spain
Márquez, L:
Hosp Mar, Gastroenterol Dept, Barcelona, Spain
Nos, P:
Hosp Univ & Politecn La Fe, Gastroenterol Dept, Valencia, Spain
Rodriguez-Pescador, A:
Hosp Univ Basurto, Gastroenterol Dept, Bilbao, Spain
Guardiola, J:
Hosp Univ Bellvitge, Gastroenterol Dept, Lhospitalet De Llobregat, Spain
García-Sepulcre, M:
Hosp Gen Univ Elche, Gastroenterol Dept, Elche, Spain
García-López, S:
Hosp Univ Miguel Servet, Gastroenterol Dept, Zaragoza, Spain
Lorente-Poyatos, RH:
Hosp Gen Univ Ciudad Real, Gastroenterol Dept, Ciudad Real, Spain
Alba, C:
Hosp Clin San Carlos, Gastroenterol Dept, Madrid, Spain
Sánchez-Ocaña, R:
Hosp U Rio Hortega, Gastroenterol Dept, Valladolid, Spain
Vera, I:
H Univ Puerta Hierro Majadahonda, Madrid, Spain
Madero, L:
Hosp Gen Univ Dr Balmis Alicante, Dept Gastroenterol, Alicante, Spain
Riestra, S:
Univ Oviedo, Inst Invest Sanitaria Principado Asturias ISPA, Oviedo, Spain
Navarro-Llavat, M:
Hosp Moises Broggi, Gastroenterol Dept, St Joan Despi, Spain
Pérez-Calle, JL:
H U Fdn Alcorcon, Gastroenterol Dept, Alcorcon, Spain
Camps, B:
Hosp Gen Granollers, Dept Gastroenterol, Granollers, Spain
Van Domselaar, M:
Hosp Univ Torrejon, Oncol Dept, Torrejon De Ardoz, Spain
Hosp Gen San Jorge, Dept Gastroenterol, Huesca, Spain
Lucendo, AJ:
Hosp Publ Gen Tomelloso, Dept Gastroenterol, Tomelloso, Spain
Martin-Arranz, MD:
Hosp La Paz, Dept Gastroenterol, Madrid, Spain
Sierra-Ausin, M:
Complejo Asistencial Univ Leon, Dept Gastroenterol, Leon, Spain
Llao, J:
Althaia Xarxa Assistencial Univ Manresa Gastroente, Dept Gastroenterol, Manresa, Spain
Carpio, D:
Complexo Hosp Pontevedra, Dept Gastroenterol, Pontevedra, Spain
Varela, P:
Hosp Univ Cabuenes, Gastroenterol Dept, Gijon, Spain
Merino, O:
Hosp Univ Cruces, Dept Gastroenterol, Baracaldo, Spain
Fernandez-Salazar, L:
Hosp Clin Univ Valladolid, Gastroenterol Dept, Valladolid, Spain
Piqueras, M:
Consorci Sanit Terrassa, Gastroenterol Dept, Terrassa, Spain
Sese, E:
Hosp Arnau Vilanova, Gastroenterol Dept, Lleida, Spain
Busquets, D:
Hosp U Girona Doctor Josep Trueta Gastroenterol De, Dept Gastroenterol, Girona, Spain
Tardillo, C:
Hosp Univ Nuestra Senora Candelaria, Gastroenterol Dept, Santa Cruz de Tenerife, Spain
Maroto, N:
Hosp Manises, Dept Gastroenterol, Manises, Spain
Riera, J:
Hosp Univ Son Llatzer, Dept Gastroenterol, Palma de Mallorca, Spain
Martinez-Flores, C:
Complejo Hosp Mancha Ctr, Dept Gastroenterol, Alcazar San Juan, Spain
:
Univ Autonoma Barcelona, Dept Med, Barcelona, Spain
Hosp Badalona Germans Trias & Pujol, Gastroenterol Dept, Badalona, Spain
|