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Description of the Inflammatory Bowel Disease Natural History in Tehran Province, Iran: Mixed Panel Approaches Publisher



Olfatifar M1 ; Aghdaei HA1 ; Pourhoseingholi MA1 ; Balaii H2 ; Nazari SH3 ; Shahrokh S1 ; Sabour S4, 5 ; Ivanchuk M6 ; Ivanchuk P7 ; Khodakarim S8 ; Zali MR1 ; Rohani P9
Authors
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Authors Affiliations
  1. 1. Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  2. 2. Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  3. 3. Prevention of Cardiovascular Disease Research Centre, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  4. 4. Department ofClinicalEpidemiology, SchoolofPublic Healthand Safety, ShahidBeheshtiUniversity ofMedicalSciences, Tehran, Iran
  5. 5. Safety Promotions and Injury, Prevention Research Centre, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  6. 6. Biological Physics and Medical Informatics Department, Bukovinian State Medical University, Chernivtsi, Ukraine
  7. 7. Internal Medicine, Physical Rehabilitation, Sports Medicine and Physical Training Department, Bukovinian State Medical University, Chernivtsi, Ukraine
  8. 8. Department of Biostatistics, School of Medicine, Shiraz University of Medical sciences, Shiraz, Iran
  9. 9. Pediatric Gastroenterology and Hepatology Research Center, Pediatrics Centre of Excellence, Pediatric's Medical Center, Tehran University of Medical Sciences, Tehran, Iran

Source: Gastroenterology and Hepatology from Bed to Bench Published:2021


Abstract

Aim: Description of the inflammatory bowel disease natural history in Tehran province. Background: Inflammatory bowel disease (IBD) is a non-homogeneous disorder with an unpredictable natural history that impairs a patient's quality of life over the course of their life. As a result, providing evidence for efficient patient management is critical. Methods: In this case series study, 198 IBD patients who were visited in our clinic at least three times routinely from Oct 2015 to May 2020 were included. Then, two panel-based approaches, the Multi-State Model (MSM) and random-effect ordered logistic, were used to deduce the clinical course of IBD, which included remission, mild, moderate to severe, and surgical states. Results For ulcerative colitis (UC), women had a slightly poorer condition for remission but better for moderate to severe and a faster transition from moderate to severe to mild (HR=1.490, 95% CI: 1.02-2.16) compared to men. For Crohn's disease (CD), they had a better condition for remission but a slightly poorer condition for the severe state and higher transition from mild to moderate to severe (HR=1.221, 95% CI: 0.471-3.22) than men. Oral 5-ASA had better efficacy in people with remission and/or mild states but not for those with moderate to severe states, especially in CD (mild to moderate to serve, HR=1.526, 95% CI: 0.59-3.89). Immunosuppressive drugs were better for patients with lower disease severity, especially with UC (mild to remission, HR=1.258, 95% CI: 0.75-2.09). Conclusion: Panel approaches have the potential efficacy to tackle the unpredictable clinical course of IBD (UC/CD). Hence, we highly recommend that our findings be included into the Iranian routine clinical environment of IBD and/or that related studies be conducted in Iran and other regions to gain a better understanding of the natural history of IBD. ©2021 RIGLD, Research Institute for Gastroenterology and Liver Diseases
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