PWE-079 Dexa Rates And Outcomes In An Ibd Population Cohort. Lessons Learnt

Abstract

Introduction Osteoporosis is one of the under diagnosed and undertreated conditions worldwide. It is estimated that 1 in 3 women and 1 in 5 men in Ireland are diagnosed with it above the age of 50 years and will be likely to become more common with the increased life expectancy. In our study, we aimed to assess the rate of screening with DEXA scans for this condition in a prospective IBD cohort and to evaluate the results. We also studied possible factors that may influence DEXA rates. Methods As part of two decades follow up study of a multi-centre Irish IBD prospective cohort from the early 1990's that was part of European Collaborative Study on IBD (EC-IBD), patients were traced and interviewed. There were 126 IBD patients from the Greater Dublin area who consented and completed the study questionnaire, following Ethical committees' approvals. In this questionnaire we evaluated DEXA frequency and possible factors that may influence it; including patient diagnosis, age, gender, family history of IBD, courses of steroids, social class, total years of education, attending gastroenterologist or a surgeon, years of loss to follow up (LTFU) and membership to the national IBD patient support group (Irish Society of Crohn's Colitis ISCC). Results were analysed with logistic regression and forward stepwise analysis using R program 3.0.1 software, taking p value <0.05 to be statistically significant. Results Of the total 126 patients only 58 (46.03%) patients had DEXA scans performed. Of those 67.44% had CD and 33.73% had UC. When evaluating DEXA results osteoporosis was diagnosed in 26.67 and 21.43% of CD and UC patients respectively. Osteopenia was diagnosed in 43.33% CD and 42.86% of UC patients. About 30% of remaining scanned patients had normal DEXA. Logistic regression analysis showed that patients with positive family history of IBD and longer years of education were more likely to have had a scan with P = 0.024 and 0.049 respectively. Other possible risk factors didn't reach statistical significance. Patients who were less compliant and LTFU were less likely to get DEXA with p = 0.045 in CD and p = 0.0336 in UC group. Conclusion Osteoporosis is an increasingly recognised condition and recently has been considered as one of the extra intestinal manifestations of IBD. Patient and doctor awareness is paramount to screening and diagnosis. Our study showed that CD patients were more likely to have DEXA scans during their disease course. The rate of osteoporosis was higher in CD patients, despite their fewer numbers when compared to UC group. Over 40% of IBD patients had osteopenia. Early detection and appropriate management will help to reduce fracture risk, improve patient quality of life in a cost effective manner.