P333 The baseline features of patients with newly diagnosed moderate-to-severe ulcerative colitis in Korea: A population-based cohort study (the MOSAIK cohort)

Abstract

Background: The incidence and prevalence of ulcerative colitis (UC) are increasing in East Asia, nationwide studies to identify clinical course and predictive factors of the disease are scarce. We are conducting a nationwide, prospective, hospital-based longitudinal cohort with a 5-year follow-up of the patients with moderate-to-severe UC to reveal the baseline characteristics and disease course in Korea. Methods: Patients with newly diagnosed moderate to severe UC from 30 tertiary hospitals were prospectively included from August 2014 to March 2017. We collected data of demographic, clinical features, and medical record. To understand the determinants of healthrelated quality of life (HRQoL), patient-reported outcomes were also collected. All completed data were transferred via the web to a central database (ClinicalTrials.gov, NCT02229344). Results: The 368 patients were enrolled and 355 patients who met eligible criteria were included. The mean age at diagnosis was 37.6 +/- 15.22 years and 210 (59.2%) patients were male with a male to female ratio of 1.4:1. Peak age at diagnosis was 20-29 years (29.6%). %). The disease extent at baseline was 46.4% for E2, 43.6% for E3 and only 10.0% for E1. Patients with severe UC showed higher proportion of extensive colitis (70.8%). Higher initial CRP and ESR were significantly associated with severity and extent (p < 0.05). Of all initial treatment utilised for the patients, most patients were treated with systemic 5-ASA (87.9%) and about half of the patients were treated with systemic steroid (48.5%). Systemic steroid uses showed a positive association with both severity and extension (p < 0.05). In terms of HRQoL, bowel symptoms, systemic symptoms, and social functions were impacted by disease severity. Presenteeism, work impairment and social impairment were significantly higher in patients with severe UC (p < 0.05). A substantial number of patients initially presented with anxiety and depression (>=11 by HADS), 16.7% and 20.6%, respectively. Also severe patients showed significantly higher depression scores compared with moderate patients (6.5 +/- 4.36 vs. 8.9 +/- 5.18, p = 0.024). Conclusions: We are the first to report baseline features of moderate to severe UC in the Korean population. It shows male-predominance, a peak occurrence in the third decade, and high proportion of left-sided and extensive colitis. Work disability and psychological distress were negatively influenced by an increased disease activity and related to quality of life. Appropriate management should be administered according to clinical characteristics and disease activity. As disease activity contributes to quality of life, there remains a need for integrated care to modify psychosocial determinants.