AUTHOR=Gutiérrez Ana , Zapater Pedro , Ricart Elena , González-Vivó María , Gordillo Jordi , Olivares David , Vera Isabel , Mañosa Míriam , Gisbert Javier P. , Aguas Mariam , Sánchez-Rodríguez Eugenia , Bosca-Watts Maia , Laredo Viviana , Camps Blau , Marín-Jiménez Ignacio , Zabana Yamile , Martín-Arranz María Dolores , Muñoz Roser , Navarro Mercè , Sierra Eva , Madero Lucía , Vela Milagros , Pérez-Calle José Lázaro , Sainz Empar , Calvet Xavier , Arias Lara , Morales Victor , Bermejo Fernando , Fernández-Salazar Luis , Van Domselaar Manuel , De Castro Luisa , Rodríguez Cristina , Muñoz-Villafranca Carmen , Lorente Rufo , Rivero Montserrat , Iglesias Eva , Herreros Belén , Busquets David , Riera Joan , Martínez-Montiel María Pilar , Roldón Marta , Roncero Oscar , Hinojosa Esther , Sierra Mónica , Barrio Jesús , De Francisco Ruth , Huguet José , Merino Olga , Carpio Daniel , Ginard Daniel , Muñoz Fernando , Piqueras Marta , Almela Pedro , Argüelles-Arias Federico , Alcaín Guillermo , Bujanda Luis , Manceñido Noemí , Lucendo Alfredo J. , Varela Pilar , Rodríguez-Lago Iago , Ramos Laura , Sempere Laura , Sesé Eva , Barreiro-de Acosta Manuel , Domènech Eugeni , Francés Rubén TITLE=Immigrant IBD Patients in Spain Are Younger, Have More Extraintestinal Manifestations and Use More Biologics Than Native Patients JOURNAL=Frontiers in Medicine VOLUME=9 YEAR=2022 URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.823900 DOI=10.3389/fmed.2022.823900 ISSN=2296-858X ABSTRACT=Background

Previous studies comparing immigrant ethnic groups and native patients with IBD have yielded clinical and phenotypic differences. To date, no study has focused on the immigrant IBD population in Spain.

Methods

Prospective, observational, multicenter study comparing cohorts of IBD patients from ENEIDA-registry who were born outside Spain with a cohort of native patients.

Results

We included 13,524 patients (1,864 immigrant and 11,660 native). The immigrants were younger (45 ± 12 vs. 54 ± 16 years, p < 0.001), had been diagnosed younger (31 ± 12 vs. 36 ± 15 years, p < 0.001), and had a shorter disease duration (14 ± 7 vs. 18 ± 8 years, p < 0.001) than native patients. Family history of IBD (9 vs. 14%, p < 0.001) and smoking (30 vs. 40%, p < 0.001) were more frequent among native patients. The most prevalent ethnic groups among immigrants were Caucasian (41.5%), followed by Latin American (30.8%), Arab (18.3%), and Asian (6.7%). Extraintestinal manifestations, mainly musculoskeletal affections, were more frequent in immigrants (19 vs. 11%, p < 0.001). Use of biologics, mainly anti-TNF, was greater in immigrants (36 vs. 29%, p < 0.001). The risk of having extraintestinal manifestations [OR: 2.23 (1.92–2.58, p < 0.001)] and using biologics [OR: 1.13 (1.0–1.26, p = 0.042)] was independently associated with immigrant status in the multivariate analyses.

Conclusions

Compared with native-born patients, first-generation-immigrant IBD patients in Spain were younger at disease onset and showed an increased risk of having extraintestinal manifestations and using biologics. Our study suggests a featured phenotype of immigrant IBD patients in Spain, and constitutes a new landmark in the epidemiological characterization of immigrant IBD populations in Southern Europe.