Ulcerative colitis in northern Portugal and Galicia in Spain.
BACKGROUND
Clinical and therapeutic patterns of ulcerative colitis (UC) are variable in different world regions. The purpose of this study was to examine two close independent southern European UC populations from 2 bordering countries and observe how demographic and clinical characteristics of patients can influence the severity of UC.


METHODS
A cross-sectional study was conducted during a 15-month period (September 2005 to December 2006) based on data of 2 Web registries of UC patients. Patients were stratified according to the Montreal Classification and disease severity was defined by the type of treatment taken.


RESULTS
A total of 1549 UC patients were included, 1008 (65%) from northern Portugal and 541 (35%) from Galicia (northwest Spain). A female predominance (57%) was observed in Portuguese patients (P < 0.001). The median age at diagnosis was 35 years and median years of disease was 7. The majority of patients (53%) were treated only with mesalamine, while 15% had taken immunosuppressant drugs, and 3% biologic treatment. Most patients in both groups were not at risk for aggressive therapy. Extensive colitis was a predictive risk factor for immunosuppression in northern Portugal and Galicia (odds ratio [OR] 2.737, 95% confidence interval [CI]: 1.846-4.058; OR 5.799, 95% CI: 3.433-9.795, respectively) and biologic treatment in Galicia (OR 6.329, 95% CI: 2.641-15.166). Younger patients presented a severe course at onset with more frequent use of immunosuppressors in both countries.


CONCLUSIONS
In a large population of UC patients from two independent southern European countries, most patients did not require aggressive therapy, but extensive colitis was a clear risk factor for more severe disease.
Barreiro-de Acosta
Manuel
M
EIGA (Inflammatory Bowel Disease Group of Galicia), Santiago de Compostela, Spain. manubarreiro@hotmail.com
Magro
Fernando
F
Carpio
Daniel
D
Lago
Paula
P
Echarri
Ana
A
Cotter
José
J
Pereira
Santos
S
Gonçalves
Raquel
R
Lorenzo
Aurelio
A
Carvalho
Laura
L
Castro
Javier
J
Barros
Luisa
L
Dias
Jorge Amil
JA
Rodrigues
Susana
S
Portela
Francisco
F
Dias
Camila
C
da Costa-Pereira
Altamiro
A
D000293:Adolescent; D000328:Adult; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D008297:Male; D011174:Portugal / Q000453:epidemiology; D011379:Prognosis; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D055815:Young Adult
D007166:Immunosuppressive Agents