Inflammatory bowel diseases in Tamil Nadu: A survey of demographics, clinical profile, and practices

Abstract

BackgroundInflammatory bowel disease (IBD) is increasingly diagnosed in South Asia. This survey by the Tamil Nadu Chapter of the Indian Society of Gastroenterology (TNISG) documents the demography, clinical profile, and therapeutic practices related to IBD in Tamil Nadu.MethodsTNISG members from 32 institutions completed an online cross‐sectional questionnaire on IBD patients from March 2020 to January 2021.ResultsOf 1295 adult IBD patients, 654 had Crohn's disease (CD), 499 ulcerative colitis (UC), and 42 IBD‐unclassified (IBD‐U). CD and UC showed a unimodal age distribution. A total of 55% were graduates or postgraduates. A positive family history was noted in 30, other risk factors were uncommon. In CD, the pattern of involvement was ileocolonic (42.8%), ileal (34.7%), colonic (18.9%), and upper gastrointestinal (3.5%); while in UC, disease was characterized as extensive (44.9%), left‐sided (41.7%), or proctitis (13.4%). Perineal disease, perianal fistulae, and bowel obstruction were noted in 4.3, 14.0, and 23.5%, respectively, of CD. The most widely used drugs were mesalamine, azathioprine, and corticosteroids. Surgery was undertaken in 141 patients with CD and 23 patients with UC. Of the 138 patients with pediatric IBD (≤16 years), 23 were characterized as very early onset IBD (VEO‐IBD), 27 as early‐onset, and 88 as adolescent IBD. VEO‐IBD were more likely to have a positive family history of IBD and were more likely to have perineal disease and to have the IBD‐U phenotype. Among pediatric IBD patients, corticosteroids, mesalamine, and azathioprine were the most commonly used medications, while 25 pediatric patients received biologics.ConclusionThis study provides important information on demography, clinical profile, and treatment practices of IBD in India.

Long‐term safety and effectiveness of azathioprine in the management of inflammatory bowel disease: A real‐world experience

“…The Indian subcontinent has witnessed a remarkable rise in the incidence and prevalence of IBD over the past few decades 31 . Logistic and financial constraints often confine biologic usage to a limited cohort of patients.…”

“…The Indian subcontinent has witnessed a remarkable rise in the incidence and prevalence of IBD over the past few decades. 31 Logistic and financial constraints often confine biologic usage to a limited cohort of patients. AZA is frequently used as first‐line therapy for maintenance of remission in CD and as second‐line after mesalamine for maintenance of remission in UC.…”

Medical management of pediatric inflammatory bowel disease in the Asia‐Pacific region: A position paper by the Asian Pan‐Pacific Society for Pediatric Gastroenterology, Hepatology, and Nutrition (APPSPGHAN) PIBD Working Group

“…The proportion of adult patients with IBD under treatment with anti‐tumor necrosis factor (anti‐TNF) in Asia differs markedly, from as high as 40% in Japan (in 2021) to as low as 10% in Malaysia (in 2019) 81,82 . A study on pediatric IBD from India reported that biologics were used in 18% of children with an onset <16 years 83 . Data on the use of other biologics such as golimumab, 84 ustekinumab, 85,86 vedolizumab, 87 and tofacitinib in childhood IBD in Asia are lacking.…”

“…81,82 A study on pediatric IBD from India reported that biologics were used in 18% of children with an onset <16 years. 83 Data on the use of other biologics such as golimumab, 84 ustekinumab, 85,86 vedolizumab, 87 and tofacitinib in childhood IBD in Asia are lacking.…”