Immigrant IBD Patients in Spain Are Younger, Have More Extraintestinal Manifestations and Use More Biologics Than Native Patients

Frontiers in Medicine

article

Ana Gutiérrez¹  Pedro Zapater²  Elena Ricart³  María González-Vivó⁷  Jordi Gordillo⁸  David Olivares⁹  Isabel Vera^1,10  Míriam Mañosa³  Javier P. Gisbert³  Mariam Aguas³  Eugenia Sánchez-Rodríguez^1,14  Maia Bosca-Watts^1,15  Viviana Laredo^1,16  Blau Camps^1,17  Ignacio Marín-Jiménez^1,18  Yamile Zabana³  María Dolores Martín-Arranz^2,21  Roser Muñoz¹  Mercè Navarro^2,22  Eva Sierra^2,23  Lucía Madero^2,24  Milagros Vela^2,25  José Lázaro Pérez-Calle^2,26  Empar Sainz^2,27  Xavier Calvet³  Lara Arias^2,29  Victor Morales^3,30  Fernando Bermejo^3,31  Luis Fernández-Salazar^3,33  Manuel Van Domselaar^3,34  Luisa De Castro^3,35  Cristina Rodríguez^3,36  Carmen Muñoz-Villafranca^3,37  Rufo Lorente^3,38  Montserrat Rivero^3,39  Eva Iglesias^4,40  Belén Herreros^4,42  David Busquets^4,43  Joan Riera^4,44  María Pilar Martínez-Montiel^4,45  Marta Roldón^4,46  Oscar Roncero^4,47  Esther Hinojosa^4,48  Mónica Sierra^4,49  Jesús Barrio^5,50  Ruth De Francisco^5,51  José Huguet^5,52  Olga Merino^5,53  Daniel Carpio^5,54  Daniel Ginard^5,55  Fernando Muñoz^5,56  Marta Piqueras^5,57  Pedro Almela^5,58  Federico Argüelles-Arias^5,59  Guillermo Alcaín^6,60  Luis Bujanda³  Noemí Manceñido^6,63  Alfredo J. Lucendo³  Pilar Varela^6,65  Iago Rodríguez-Lago^6,66  Laura Ramos^6,68  Laura Sempere¹  Eva Sesé^6,69  Manuel Barreiro-de Acosta^7,70  Eugeni Domènech³  Rubén Francés² 

[1] Servicio Medicina Digestiva, Hospital General Universitario Alicante;IIS Isabial, Hospital General Universitario Alicante;Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas ,(CIBERehd), Instituto de Salud Carlos III;Unidad Farmacología Clínica, Hospital General Universitario Alicante;Instituto IDIBE, Universidad Miguel Hernández;Servicio de Medicina Digestiva Hospital Clínic, Instituto de Investigaciones Biomédicas August Pi i Sunyer;Servicio Medicina Digestiva, Hospital del Mar, IMIM ,(Hospital del Mar Medical Research Institute);Servicio Patología Digestiva, Hospital de la Santa Creu I Sant Pau;Servicio Medicina Digestiva, Hospital Universitario Clínico San Carlos;Servicio Aparato Digestivo, Hospital Universitario Puerta de Hierro;Servicio Aparato Digestivo, Hospital Universitari Germans Trias I Pujol;Servicio de Aparato Digestivo, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa ,(IIS-IP), Universidad Autónoma de Madrid;Servicio Medicina Digestiva, Hospital Universitario La Fé;Servicio Medicina Digestiva, Hospital Universitario Ramón y Cajal;Servicio Medicina Digestiva, Hospital Clínico Universitario de Valencia;Servicio Medicina Digestiva, Hospital Clinico Universitario Lozano Blesa;Servicio Medicina Digestiva, Hospital Universitario de Bellvitge;Servicio Medicina Digestiva, Hospital Gregorio Marañón;Gastroenterology Department, Instituto de Investigación Biomédica Gregorio Marañón IiSGM;Servicio Medicina Digestiva, Hospital Universitari Mútua Terrassa;Servicio Medicina Digestiva, Hospital La Paz;Servicio Medicina Digestiva, Hospital de Sant Joan Despí Moisès Broggi;Servicio Medicina Digestiva, Hospital Universitario Miguel Servert;Servicio Medicina Digestiva, Hospital General Universitario de Elche;Servicio Medicina Digestiva, Hospital Nuestra Señora de la Candelaria;Servicio Medicina Digestiva, Hospital Universitario Fundación de Alcorcón;Servicio Medicina Digestiva, Hospital Sant Joan de Déu - Althaia;Unitat Malalties Digestives, Hospital de Sabadell, Institut Universitari Parc Tauli, Universidad Autónoma de Barcelona;Servicio Medicina Digestiva, Hospital Universitario de Burgos;Servicio Medicina Digestiva, Hospital General de Granollers;Servicio Medicina Digestiva, Hospital de Fuenlabrada, Fuenlabrada;IIS Hospital La Paz IdiPaz-Madrid;Servicio Medicina Digestiva, Hospital Clínico de Valladolid;Servicio Medicina Digestiva, Hospital de Torrejón de Ardoz;Department of Gastroenterology;Servicio Medicina Digestiva, Complejo Hospitalario de Navarra;Servicio Medicina Digestiva, Hospital Universitario de Basurto;Servicio Medicina Digestiva, Hospital General Ciudad Real;Servicio Medicina Digestiva, Hospital Universitario Marqués de Valdecilla and IDIVAL;Servicio Medicina Digestiva, Hospital Universitario Reina Sofía;Instituto Maimónides de Investigación Biomédica de Córdoba;Servicio Medicina Digestiva, Hospital Marina Baixa;Servicio Medicina Digestiva, Hospital de Girona Dr. Trueta/ICO;Servicio Medicina Digestiva, Hospital Universitario Son LLàtzer;Servicio Medicina Digestiva, Hospital 12 de Octubre;Servicio Cirugía General y del Aparato Digestivo, Hospital San Jorge;Servicio Medicina Digestiva, Hospital General La Mancha Centro;Servicio Medicina Digestiva, Hospital de Manises;Servicio Medicina Digestiva, Complejo Asistencial Universitario de León;Hospital Universitario Rio Hortega;Hospital Universitario Central de Asturias and ISPA;Consorcio Hospital General Universitario de Valencia;Servicio Medicina Digestiva, Hospital de Cruces;Complejo Hospitalario Universitario Pontevedra;Servicio Medicina Digestiva, Hospital Universitario Son Espases;Servicio Medicina Digestiva, Hospital Clínico Universitario Salamanca;Servicio Medicina Digestiva;Servicio Medicina Digestiva, Hospital General Universitario Castellón;Servicio Medicina Digestiva, Hospital Universitario Virgen Macarena;Servicio Medicina Digestiva, Hospital Clínico Virgen de la Victoria;Servicio Medicina Digestiva, Hospital Universitario Donostia;Instituto Biodonostia, Universidad Pais Vasco;Servicio Medicina Digestiva, Hospital Infanta Sofía;Servicio Medicina Digestiva, Hospital General Tomelloso;Servicio Medicina Digestiva, Hospital Cabueñes;Servicio de Aparato Digestivo, Hospital Universitario de Galdakao;Facultad de Medicina, University of Deusto;Servicio Medicina Digestiva, Hospital Universitario La Laguna;Servicio Medicina Digestiva, Hospital Arnau de Vilanova;Servicio Aparato Digestivo, Hospital Universitario Santiago;Hepatic and Intestinal Immunobiology Group, Dpto. Medicina Clínica, Universidad Miguel Hernández;Instituto de Investigación, Desarrollo e Innovación en Biotecnología Sanitaria de Elche ,(IDiBE), Universidad Miguel Hernández

关键词: immigrant;    phenotype;    biologics;    inflammatory bowel disease;    Crohn's disease;    ulcerative colitis;   

DOI  :  10.3389/fmed.2022.823900

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background Previous studies comparing immigrant ethnic groups and native patients with IBD have yielded clinical and phenotypic differences. To date, no study has focused on the immigrant IBD population in Spain. Methods Prospective, observational, multicenter study comparing cohorts of IBD patients from ENEIDA-registry who were born outside Spain with a cohort of native patients. Results We included 13,524 patients (1,864 immigrant and 11,660 native). The immigrants were younger (45 ± 12 vs. 54 ± 16 years, p < 0.001), had been diagnosed younger (31 ± 12 vs. 36 ± 15 years, p < 0.001), and had a shorter disease duration (14 ± 7 vs. 18 ± 8 years, p < 0.001) than native patients. Family history of IBD (9 vs. 14%, p < 0.001) and smoking (30 vs. 40%, p < 0.001) were more frequent among native patients. The most prevalent ethnic groups among immigrants were Caucasian (41.5%), followed by Latin American (30.8%), Arab (18.3%), and Asian (6.7%). Extraintestinal manifestations, mainly musculoskeletal affections, were more frequent in immigrants (19 vs. 11%, p < 0.001). Use of biologics, mainly anti-TNF, was greater in immigrants (36 vs. 29%, p < 0.001). The risk of having extraintestinal manifestations [OR: 2.23 (1.92–2.58, p < 0.001)] and using biologics [OR: 1.13 (1.0–1.26, p = 0.042)] was independently associated with immigrant status in the multivariate analyses. Conclusions Compared with native-born patients, first-generation-immigrant IBD patients in Spain were younger at disease onset and showed an increased risk of having extraintestinal manifestations and using biologics. Our study suggests a featured phenotype of immigrant IBD patients in Spain, and constitutes a new landmark in the epidemiological characterization of immigrant IBD populations in Southern Europe.

【 授权许可】

CC BY