Description of the Cohort of Patients From the Center of Excellence in Inflammatory Bowel Disease at the International Hospital of Colombia

Background: In Colombia, there are currently 5 centers of excellence certified by the Pan American Crohn’s and Colitis Organization (PANCCO) and one of them is the Hospital Internacional de Colombia (HIC), which is the only one that is certified and serves the population of eastern Colombia. It is reported that in this area of the country are the departments with the lowest prevalence of the disease, however, the increase in population density and improved urban development have been increasing the prevalence of this disease in this region, so currently in this center of excellence is providing quality care focused on the different stages and levels of the disease, guaranteeing adequate treatment and contributing to the rational and pertinent use of resources destined to the care of IBD patients in our hospital, based on a multidisciplinary approach with standardized clinical care practices that guarantee safety and satisfaction for the patient and his or her family. Objective: Description of the cohort of patients who have been admitted to the HIC IBD Center of Excellence since the second semester of 2022 date on which certification as a center of excellence was received. Materials and Methods: Descriptive cross-sectional observational cross-sectional study of diagnosed pediatric and adult IBD patients admitted to the HIC Inflammatory Bowel Disease Center of Excellence since receiving PANCCO certification. Results: 74 patients, 56.76% were women. The average age was 39.47 years, with a minimum age of 7 years and a maximum age of 80 years, 5 patients were pediatric. The 72.97% are Ulcerative Colitis (UC) (35% pancolitis, 60% left colitis and 5% proctitis) and 27.03% Crohn’s Disease (CD) (70% ileal, 20% ileocolonic and 10% colonic) with 10% with fistulizing involvement and 15% stenosing. In UC 22.2% are receiving biologic therapy, being infliximab the most used biologic 41%, adalimumab 25%, vedolizumab 25% and 9% golimumab. The use of small molecules (tofacitinib) is 13%, 59.3% are on 5-ASA. In CD 45% have required biological therapy mostly with infliximab 67%, followed by the use of adalimumab11%, certolizumab 11% and ustekinumab 11%, 10.8% continue with the use of immunosuppressant (azathioprine and 8% use of methotrexate). In the entire cohort only 16.2% are currently using steroids. Hospitalization was required in 18.9% due to disease activity, with a higher admission in patients with ulcerative colitis. Only one colectomy was performed in a patient with stenosing colonic Crohn’s disease with the presence of high-grade dysplasia. There was one patient who died from Covid-19, who was in remission of UC in management with tofacitinib without requiring corticoid. Conclusions: This study provides valuable information on IBD in eastern Colombia, showing that there is a predominance of UC, however, with greater use of biologic therapy in patients with CD despite low percentages of stenosing and fistulizing disease compared to other Latin American cohorts, and a population with low use of corticosteroids. So far, with strict monitoring and accompaniment by the multidisciplinary team and the head nurse, there have been few hospitalizations with only one patient requiring surgery, which was secondary to low-grade dysplasia.