Observational Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 26, 2022; 10(30): 10921-10930
Published online Oct 26, 2022. doi: 10.12998/wjcc.v10.i30.10921
Clinical and epidemiological features of ulcerative colitis patients in Sardinia, Italy: Results from a multicenter study
Salvatore Magrì, Mauro Demurtas, Maria Francesca Onidi, Marcello Picchio, Walter Elisei, Manuela Marzo, Federica Miculan, Roberto Manca, Maria Pina Dore, Bianca Maria Quarta Colosso, Antonio Cicu, Luigi Cugia, Monica Carta, Laura Binaghi, Paolo Usai, Mariantonia Lai, Fabio Chicco, Massimo Claudio Fantini, Alessandro Armuzzi, Giammarco Mocci
Salvatore Magrì, Department of Medical Sciences and Public Health, University of Cagliari, Monserrato 09042, Italy
Salvatore Magrì, Endoscopy Unit, Humanitas Istituto Clinico Catanese, Catania 95045, Italy
Mauro Demurtas, Endoscopy Unit, San Martino Hospital, Oristano 09170, Italy
Maria Francesca Onidi, Laura Binaghi, Giammarco Mocci, Gastroenterology Unit, Brotzu Hospital, Cagliari 09121, Italy
Marcello Picchio, Division of General Surgery, Ospedale Civile P Colombo, Velletri 00049, Italy
Walter Elisei, Gastroenterology Unit, San Camillo Forlanini Hospital, Rome 00152, Italy
Manuela Marzo, Internal Medicine and Gastroenterology Department, Cardinale Panico Hospital, Tricase 73039, Italy
Federica Miculan, Department of Surgery, San Martino Hospital, Oristano 09170, Italy
Roberto Manca, Division of Gastroenterology, Santissima Trinità Hospital, Cagliari 09121, Italy
Maria Pina Dore, Dipartimento di Medicina Clinica e Sperimentale, University of Sassari, Sassari 07100, Italy
Bianca Maria Quarta Colosso, Department of Medical Science and Public Health, University of Sassari, Sassari 07100, Italy
Antonio Cicu, Unit of Gastroenterology, ASL Sassari, Sassari 07100, Italy
Luigi Cugia, Monica Carta, Gastroenterology Unit, Santissima Annunziata Hospital, Sassari 07100, Italy
Paolo Usai, Fabio Chicco, Medical Science and Public Health, University of Cagliari, Cagliari 09042, Italy
Mariantonia Lai, Medical Sciences and Public health, Presidio Policlinico of Monserrato, Cagliari, Monserrato 09042, Cagliari, Italy
Massimo Claudio Fantini, Department of Internal Medicine, University of Rome Tor Vergata, Rome 00133, Italy
Alessandro Armuzzi, IBD Unit, Policlinico Universitario Gemelli, Rome 00168, Italy
Author contributions: Magrì S and Mocci G performed the study design, data capture, and data validation; Mgrì S, Demurtas M, and Picchio M performed the statistical analyses; Magrì S drafted the manuscript; Magrì S, Demurtas M, Onidi MF, Picchio M, Elisei W, Marzo M, Miculan F, Manca R, Dore MP, Quarta Colosso BM, Cicu A, Cugia L, Pisanu R, Carta M, Binaghi L, Usai P, Lai M, Chicco F, Fantini MC, Cabras F, Armuzzi A, and Mocci G performed the data capture and revised the manuscript; Mocci G approved the final version of the manuscript.
Institutional review board statement: The research project has been approved by the Ethics Board (Prot. PG/2016/17911).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Salvatore Magrì, MD, Academic Research, Department of Medical Sciences and Public Health, University of Cagliari, Presidio Policlinico of Monserrato, Cagliari, SS 554 km 4500, Monserrato 09042, Italy. salvo10ms@libero.it
Received: August 9, 2021
Peer-review started: August 9, 2021
First decision: August 29, 2021
Revised: September 6, 2021
Accepted: August 22, 2022
Article in press: August 22, 2022
Published online: October 26, 2022
Abstract
BACKGROUND

There are little data on the epidemiological and clinical features of adult patients with ulcerative colitis (UC) in the different Italian regions, mainly derived from the absence of a national registry. This prevents correct interpretation of the disease burden.

AIM

To assess the main clinical and epidemiological features of adult patients diagnosed with UC in Sardinia, Italy.

METHODS

We performed a multicenter, observational, cross-sectional study that included adult patients with UC enrolled in seven gastroenterology unit centers in Sardinia. Data were obtained from the patients’ medical records and from a questionnaire administered at the inclusion visit.

RESULTS

Four hundred and forty-two patients with UC were included. The median age at diagnosis was 39 years (interquartile range 28-48). After a median disease duration of 10 years, 53 patients experienced proximal extension of proctitis or left-sided colitis. Seventy-five patients developed extraintestinal manifestations. Nineteen patients (4.3%) developed cancer: two with colorectal cancer and seventeen with extracolonic cancers. Mesalazine (5-ASA) remains the mainstay of treatment for UC. Overall, 95 patients (21.5%) were treated with one or more biologic agents, whereas 15 patients (3.4%) underwent surgery, mostly colectomy.

CONCLUSION

Our results provide important insights into the clinical and epidemiological features of patients with UC, and while waiting for a national Italian registry, present eligible data on the UC population in Sardinia.

Keywords: Inflammatory bowel disease-basic, Inflammatory bowel disease-clinical, Ulcerative colitis, Epidemiology, Natural history, Treatment

Core Tip: There are little data on the epidemiological and clinical features of adult ulcerative colitis patients in the different Italian regions, mainly derived from the absence of a national registry. This prevents correct appraisal of the disease burden. A population-based observational study evaluating an entire population in a defined geographic area over an extended period of time is ideal to inform the natural history of a disease and to avoid selection biases associated with referral center cohort studies.