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S888 Phenotype and Characteristics of Inflammatory Bowel Disease in the Gulf Region: Results From the First Prospective IBD Database in the United Arab Emirates

Introduction: Although a sharp rise in IBD incidence has been observed in the Gulf region, there are only limited data describing patient demographics and phenotype, and none from the United Arab Emirates. As a first step towards a regional inception cohort and through establishing the first IBD prospective database in the region, we aimed to characterize IBD manifestations in this region of the world among Emiratis and compared them to expatriates. Methods: Consecutive adult patients with Crohn’s disease (CD) and ulcerative colitis (UC) were identified through a prospectively maintained IBD database (“IBDCCAD”) at a tertiary care center from 2016 to 2021. We aimed to assess demographics, disease characteristics and phenotype among UAE Emiratis and expatriates from various ethnic backgrounds. Results: A total of 786 patients with IBD were included (41% female, 21% smokers). 555 (70.6%) were Emirati, the rest were expatriates. Most patients were diagnosed with CD (57.1%), the rest with UC. Average age at diagnosis was 26.1 years. 12% had family history of IBD. For UC, most patients had extensive colitis (194 patients, 57.5%), 83 (24.6%) had proctitis and 60 (17.8%) had left sided colitis. In CD, 173 (39%) patients had ileocolonic disease (L3), 165 (38%) patients had ileal disease (L1), 102 (23%) patients had colonic disease (L1). Inflammatory, fibrostenotic and penetrating phenotype were found in 87.6%, 4.7% and 7.7% of patients, respectively. Only 59 (17.5%) of patients with UC required biologics during their disease course compared with 221 (49%) patients with CD. Among patients with CD, Emiratis were more likely to receive a biologic than expatriates (52.2% vs 39.1%, P50.013). Perianal fistulizing disease was more common in UAE nationals than in expatriates (35% vs 21% P50.004). Conclusion: In this first prospective IBD registry in the Gulf region with rising IBD incidence, CD was found to be more common than UC and more often required biologics. Biologic use and perianal disease were more common among UAE nationals, perhaps signaling a more aggressive disease course in this population. Further data are needed to better characterize IBD in this population and explore possible genetic and environmental contributing factors.