Background The current evidence suggests ethnic distinctions in IBD phenotype, and differences in the provision of treatment have been reported. This multi-centre cohort study utilised the UK IBD BioResource dataset to evaluate phenotypic differences between South Asian (SA) and White (WH) IBD, and to explore if these were associated with differences in treatment. Methods Phenotypic and outcome data were extracted from the IBD BioResource. Chi2 (categorical data) and Mann-Whitney U (continuous data) tests were used. Propensity score matching (PSM) accounted for age at diagnosis, sex, smoking status, disease location and behaviour and perianal disease (CD). Differences in medication use (multivariable logistic regression) and surgical outcomes (Kaplan-Meier and Cox regression analysis) were assessed in propensity-matched (PM) cohorts. Results 33,157 (31,932 WH; 1225 SA) individuals were included (48.1% CD, 45.4% UC, 6.5% IBD-U). UC was the predominant disease subtype in SA (UC, SA 57.3% vs WH 44.9%, p<0.001). SA were younger at diagnosis [CD, SA 24 (IQR 17-36) vs WH 26 (IQR 19-39) years, p<0.001; UC, SA 29 (IQR 22-38) vs WH 35 (25-48) years, p<0.001]. SA CD had less ileal disease (SA 30.3% vs WH 38.4%, padj=0.008), and more perianal involvement (SA 38.5% vs WH 32.3%, p=0.009) than WH. SA CD had less stricturing disease (SA 16.9% vs WH 25.6%, padj<0.001). SA UC were more likely to have extensive disease (SA 41.7% vs WH 34.1%, padj<0.001). Initial analyses in non-PSM cohorts showed that fewer SA CD underwent surgery [SA (n=157,37.4%) vs WH (n=7532,50.4%), p<0.001], and that similar proportions of SA (n=33,5.1%) and WH (n=747,5.5%; p=0.15) UC underwent a colectomy. PSM was used to match 355 SA to 355 WH in CD, and 525 SA to 525 WH in UC. Variables were well-balanced. There were no differences in 5-ASA, corticosteroid, thiopurine, anti-TNF or Vedolizumab use (Table 1). In CD, 126 (36.5%) SA and 152 (44.7%) had surgery. Survival analysis in CD showed no difference in the time to surgery (Fig 1A, log-rank 0.28). SA ethnicity was not associated with increased risk of surgery in CD (HR 0.82, 95% CI 0.63-1.07, p=0.14). In UC, 25 (4.8%) and 37 (7.1%) WH had a colectomy. There was no significant difference in the time to colectomy (Fig 1B, log-rank 0.12) nor was SA ethnicity associated with an increased risk of having a colectomy (HR 0.65, 95% CI 0.39-1.11, p=0.12). Conclusion In the largest analysis of SA IBD to date, we have demonstrated phenotypic differences associated with ethnicity. Accounting for these variations, we have shown comparable provision of medical and surgical treatment in SA and WH. These findings indicate consistent care of IBD patients from different ethnic backgrounds in the UK.

中文翻译：

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OP07 尽管存在表型差异，但南亚和白人的 IBD 治疗方法一致：使用 IBD BioResource 对 33,157 名患者进行的研究

背景 目前的证据表明 IBD 表型存在种族差异，并且已报道了治疗提供方面的差异。这项多中心队列研究利用英国 IBD BioResource 数据集来评估南亚 (SA) 和白人 (WH) IBD 之间的表型差异，并探讨这些差异是否与治疗差异相关。方法 从 IBD 生物资源中提取表型和结果数据。使用 Chi2（分类数据）和 Mann-Whitney U（连续数据）检验。倾向评分匹配（PSM）考虑了诊断时的年龄、性别、吸烟状况、疾病部位和行为以及肛周疾病（CD）。在倾向匹配 (PM) 队列中评估药物使用（多变量逻辑回归）和手术结果（Kaplan-Meier 和 Cox 回归分析）的差异。结果 纳入 33,157 名（31,932 WH；1225 SA）个体（48.1% CD、45.4% UC、6.5% IBD-U）。UC是SA中的主要疾病亚型(UC，SA 57.3％ vs WH 44.9％，p＜0.001)。SA 诊断时较年轻 [CD、SA 24 (IQR 17-36) vs WH 26 (IQR 19-39) 岁，p<0.001；UC、SA 29 (IQR 22-38) 对比 WH 35 (25-48) 岁，p<0.001]。SA CD 的回肠疾病较少（SA 30.3% vs WH 38.4%，padj=0.008），但肛周受累较多（SA 38.5% vs WH 32.3%，p=0.009）。SA CD具有较少的狭窄疾病(SA 16.9％对WH 25.6％，padj＜0.001)。SA UC更有可能患有广泛的疾病(SA 41.7% vs WH 34.1%，padj＜0.001)。非 PSM 队列的初步分析表明，接受手术的 SA CD 较少 [SA (n=157,37.4%) 与 WH (n=7532,50.4%)，p<0.001]，并且 SA 的比例相似 (n=33) ,5.1%) 和 WH (n=747,5.5%; p=0.15) UC 接受了结肠切除术。PSM 用于将 CD 中的 355 SA 与 355 WH 匹配，以及 UC 中的 525 SA 与 525 WH 匹配。变量平衡良好。5-ASA、皮质类固醇、硫嘌呤、抗 TNF 或维多珠单抗的使用没有差异（表 1）。在 CD 中，126 例 (36.5%) SA 和 152 例 (44.7%) 接受了手术。CD 的生存分析显示手术时间没有差异（图 1A，对数秩 0.28）。SA 种族与 CD 手术风险增加无关（HR 0.82，95% CI 0.63-1.07，p=0.14）。在 UC 中，25 名 (4.8%) 和 37 名 (7.1%) WH 接受了结肠切除术。结肠切除术的时间没有显着差异（图 1B，对数秩 0.12），SA 种族与结肠切除术风险增加也没有相关性（HR 0.65，95% CI 0.39-1.11，p=0.12）。结论 在迄今为止最大规模的 SA IBD 分析中，我们证明了与种族相关的表型差异。考虑到这些差异，我们显示了南澳和白人的医疗和手术治疗的可比性。这些发现表明英国不同种族背景的 IBD 患者得到了一致的护理。