Bahar Saberzadeh-Ardestani
1 
, Amir Ali Khosravi
1, Fariborz Mansour-Ghanaei
2, Homayoon Vahedi
1, Nadieh Baniasadi
3, Mohammadreza Seyyedmajidi
4, Baran Parhizkar
5, Ahmad Hormati
1, Sayed Jalalledin Naghshbandi
5, Somaieh Matin
6,7, Amir Abbas Hassan Zadeh
8, Tarang Taghvaei
9, Mohsen Bahrami
10, Mandana Rafeey
11, Mitra Ahadi
12, Hassan Vossoughinia
12, Hashem Muosavi
10, Shahsanam Gheibi
13, Roya-Sadat Hosseini-Hemmatabadi
14, Abbas Yazdanbod
15, Saied Matinkhah
16, Farshad Sheikh Esmaeili
5, Hafez Fakheri
9, Seyed Hamid Moosavy
17, Iradj Maleki
9, Siavosh Nasseri-Moghaddam
1, Bardia Khosravi
1, Fatemeh Farahmand
18, Mehri Najafi
19, Hosein Alimadadi
20, Masoud Malekzadeh
1, Amir Anushiravani
1, Amir Kasaeian
21,22,23 , Sudabeh Alatab
1, Anahita Sadeghi
1, Amir Reza Radmard
24, Shadi Kolahdoozan
1, Zeynab Rajabi
25, Ali Reza Sima
1,10* 1 Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
2 Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Guilan, Iran
3 Noncommunicable Diseases Research Center, Bam University of Medical Sciences, Bam, Iran
4 Golestan Research Center of Gastroenterology, Golestan University of Medical Science, Gorgan, Iran
5 Liver and Digestive Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
6 Department of Internal Medicine, School of Medicine, Lung Diseases Research Center, Ardabil, Iran
7 Digestive Diseases Research Center, Imam Khomeini Hospital, Ardabil University of Medical Sciences, Ardabil, Iran
8 Nazeran Hospital, Mashhad, Iran
9 Gut and Liver Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
10 Sasan Alborz Biomedical Research Center, Masoud Gastroenterology and Hepatology Center, Tehran, Iran
11 Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
12 Department of Gastroenterology and Hepatology, Mashhad University of Medical Sciences, Mashhad, Iran
13 Maternal and Childhood Obesity Research center, Urmia University of Medical Sciences, Urmia, Iran
14 Shahid Sadoughi University, Yazd, Iran
15 Digestive Disease Research Center, Ardabil University of Medical Science, Ardabil, Iran
16 Isfahan University of Medical Sciences, Isfahan, Iran
17 Shahid Mohammadi Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
18 Pediatric Gastroenterology and Hepatology in Children Research Center, Tehran University of Medical Sciences, Tehran, Iran
19 Tehran University of Medical Sciences, Tehran, Iran
20 Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran
21 Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
22 Research Center for Chronic Inflammatory Diseases, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
23 Clinical Research Development Unit, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
24 Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
25 Department of Internal Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Abstract
Background: Data on the epidemiology of inflammatory bowel disease (IBD) in the Middle East are scarce. We aimed to describe the clinical phenotype, disease course, and medication usage of IBD cases from Iran in the Middle East.
Methods: We conducted a cross-sectional study of registered IBD patients in the Iranian Registry of Crohn’s and Colitis (IRCC) from 2017 until 2022. We collected information on demographic characteristics, past medical history, family history, disease extent and location, extra-intestinal manifestations, IBD medications, and activity using the IBD-control-8 questionnaire and the Manitoba IBD index, admissions history, history of colon cancer, and IBD-related surgeries.
Results: In total, 9746 patients with ulcerative colitis (UC) (n=7793), and Crohn’s disease (CD) (n=1953) were reported. The UC to CD ratio was 3.99. The median age at diagnosis was 29.2 (IQR: 22.6,37.6) and 27.6 (IQR: 20.6,37.6) for patients with UC and CD, respectively. The male-to-female ratio was 1.28 in CD patients. A positive family history was observed in 17.9% of UC patients. The majority of UC patients had pancolitis (47%). Ileocolonic involvement was the most common type of involvement in CD patients (43.7%), and the prevalence of stricturing behavior was 4.6%. A prevalence of 0.3% was observed for colorectal cancer among patients with UC. Moreover,15.2% of UC patients and 38.4% of CD patients had been treated with anti-tumor necrosis factor (anti-TNF).
Conclusion: In this national registry-based study, there are significant differences in some clinical phenotypes such as the prevalence of extra-intestinal manifestations and treatment strategies such as biological use in different geographical locations.