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Publications

Journal Article Multicenter Study Ppublish

PubMed: 42832339 DOI: 10.1093/ecco-jcc/jjag145

Epidemiology of inflammatory bowel disease in the Middle East and North Africa: a multinational, tertiary care registry (MIRAGE) study.

J Crohns Colitis 20(9)

Authors: Mohammad Shehab, Nahla Azzam, Ahmed Al-Hindawi, Fatema Alrashed, Badr Al-Bawardy, Sara Abid, Abdulelah A Bashandi, Reem M AlShihri, Mariam Mukhtar, Omar Saadah, Othman Alharbi, Ahmed Al-Darmaki, Shamsa Al Harthi, Khalid Al-Ejji, Ahmed Ayash, Abdullah Al Sahli, Nadia Khamees, Osama E Salem, Eman A Mohamed, Maha Maher, Gehad Daba, Ahmed Alwassief Helal, Mohamad Abdulhakim Alnassar, Ahmed Alfadhli, Mohammed Nabil Quraishi, Shane W Goodwin, Yuhong Yuan, Mahmoud Mosli, Vipul Jairath

Affiliations

  • Program of Medicine, College of Medicine and Health Sciences, Abdullah Al Salem University, Khaldiya, Kuwait.
  • Division of Gastroenterology and Hepatology, Department of Medicine, McGill University Health Center, Montreal, Canada.
  • Division of Gastroenterology, Department of Internal Medicine, Mubarak Alkabeer University Hospital, Jabriya, Kuwait.
  • Division of Gastroenterology, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
  • Department of Internal Medicine, Creighton University School of Medicine, Omaha, NE, United States.
  • Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Jabriya, Kuwait.
  • Division of Gastroenterology and Hepatology, Department of Internal Medicine, King Faisal Specialist Hospital, Riyadh, Saudi Arabia.
  • College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
  • Department of Internal Medicine, Section of Digestive Diseases, Yale School of Medicine, New Haven, CT, United States.
  • Department of Internal Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
  • Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
  • Inflammatory Bowel Disease Unit, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia.
  • Division of Gastroenterology, Department of Medicine, Royal Hospital, Muscat, Oman.
  • Division of Gastroenterology, Department of Medicine, Oman Medical Specialty Board, Muscat, Oman.
  • Department of Medicine, Khawlah Hospital, Muscat, Oman.
  • Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar.
  • Division of Gastroenterology, Department of Internal Medicine, Jordan University Hospital, Amman, Jordan.
  • Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
  • Department of Gastroenterology and Hepatology, Mansoura Facility of Medicine, Mansoura University, Mansoura, Egypt.
  • Division of Gastroenterology, Department of Medicine, Sultan Qaboos University Hospital, Seeb, Oman.
  • Department of Gastroenterology, Sheikh Shakhbout Medical City, Pure Health, Abu Dhabi, United Arab Emirates.
  • Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom.
  • Department of Medicine, Lawson Health Research Institute, London Health Science Center, London, ON, Canada.
  • Division of Gastroenterology, Department of Medicine, Western University, London, ON, Canada.
  • Department of Epidemiology & Biostatistics, Western University, London, ON, Canada.

Abstract

BACKGROUND AND AIMS

Inflammatory bowel disease (IBD) is increasing in the Middle East and North Africa (MENA), yet region-specific evidence on phenotype and treatment patterns remains limited. We aimed to characterize IBD epidemiology, clinical phenotypes, and therapy use across MENA centers.

METHODS

This was a multicenter cross-sectional study across 13 centers in seven MENA countries. Adults with ulcerative colitis (UC), Crohn's disease (CD), or IBD-unclassified (IBD-U) were included. Demographics, Montreal phenotype/behavior, smoking status, disease duration, perianal disease, and therapies were collected. Descriptive statistics and between-group comparisons were performed.

RESULTS

We analyzed 10 340 patients (52% UC, 45% CD, 3% IBD-U). Mean age was 39.79 ± 14.4 years in UC and 34.57 ± 12.9 years in CD (P < .0001). UC patients were slightly more often female (51.6%), while CD patients were male-predominant (59.0%). Current smoking was more common in CD than in UC (12.0% vs 5.6%). Mean disease duration was 9.73 ± 7.5 years, longest in Jordan (14.1 years) and shortest in Qatar (2.45 years; P < .001). Biologic exposure differed by subtype (P < .001), with the highest rate in CD (57.9%). In UC, extensive colitis (E3) was the most common phenotype. In CD, ileocolonic involvement (L3) predominated with mainly non-stricturing, non-penetrating behavior (B1). Perianal disease affected approximately 13% overall, with rates varying by country, highest in UAE and lowest in Egypt and Qatar.

CONCLUSION

This multi-country hospital-based registry study helps define contemporary IBD patterns in MENA: slight UC predominance, high rates of extensive UC and ileocolonic B1 CD, and heterogeneous biologic use. Our data provide insights into regional IBD epidemiological trends and treatment adoption.

MeSH

Registries, Epidemiology, Colitis, Phenotype, Multiple Chronic Conditions, Inflammatory Bowel Diseases, Therapeutics, Tertiary Healthcare, Smoking, Colitis, Ulcerative